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儿童和青年使用BeGraft主动脉支架治疗主动脉缩窄的早期疗效

Early outcomes of the treatment of aortic coarctation with BeGraft aortic stent in children and young adults.

作者信息

Kavurt Ahmet V, Gürsu Hazım A, Kaş Gökçe, Özdemiroğlu Nevin, Bağrul Denizhan, Gül Ayşe E K, Ece İbrahim, Çetin İbrahim I

机构信息

Department of Pediatric Cardiology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.

Department of Pediatric Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.

出版信息

Cardiol Young. 2023 Mar;33(3):354-361. doi: 10.1017/S1047951122003237. Epub 2022 Oct 19.

Abstract

We report our experience and early outcomes of using the BeGraft aortic stent in children, adolescents, and young adults. BeGraft aortic stent (Bentley InnoMed, Hechingen, Germany) requires a smaller long sheath compared to other covered stents, and it has a low profile and adequate radial power. With these features, it can overcome some limitations in the treatment of coarctation, especially in children. This is a single centre retrospective analysis of 11 implanted BeGraft aortic stents in coarctation of the aorta between July 2020 and November 2021. The eleven stents were successfully implanted in 11 patients (10 males). The median age of the patients was 13.7 years (interquartile range 12-16 years), and the median weight was 43 kg (interquartile range 35-62 kg). In five patients, after the stents were opened completely by the first balloon, they were exchanged with a Z-MED II™ balloon, 1-3 mm larger in diameter, and the stents were redilated. The median catheter-derived systolic peak-to-peak pressure gradient was 23 mm Hg (interquartile range 16-37 mmHg) before the procedure and 3 mm Hg (interquartile range 1-5 mm Hg) after the procedure. Except for the partial femoral artery thrombosis in two patients, no other procedural complications were observed in our study. The median follow-up duration was 5 months (interquartile range 2-12 months). During follow-up, only one patient (9%) had stent narrowing that required dilation. Our initial results and short-term follow-up showed that the BeGraft aortic stent implantation and redilation can be performed effectively, safely, and successfully in the treatment of coarctation of the aorta.

摘要

我们报告了使用BeGraft主动脉支架治疗儿童、青少年和年轻成人的经验及早期结果。与其他覆膜支架相比,BeGraft主动脉支架(德国黑兴根的本特利创新医疗公司)所需的长鞘较小,外形低轮廓且具有足够的径向支撑力。凭借这些特性,它能够克服主动脉缩窄治疗中的一些局限性,尤其是在儿童中。这是一项单中心回顾性分析,纳入了2020年7月至2021年11月期间为11例主动脉缩窄患者植入的BeGraft主动脉支架。这11枚支架成功植入了11例患者(10例男性)。患者的中位年龄为13.7岁(四分位间距12 - 16岁),中位体重为43千克(四分位间距35 - 62千克)。5例患者在首个球囊将支架完全打开后,更换为直径大1 - 3毫米的Z - MED II™球囊,并对支架进行再次扩张。术前导管测量的收缩期峰 - 峰压力梯度中位数为23毫米汞柱(四分位间距16 - 37毫米汞柱),术后为3毫米汞柱(四分位间距1 - 5毫米汞柱)。除2例患者出现股动脉部分血栓形成外,本研究未观察到其他手术并发症。中位随访时间为5个月(四分位间距2 - 12个月)。随访期间,仅1例患者(9%)出现支架狭窄需要扩张。我们的初步结果和短期随访表明,BeGraft主动脉支架植入及再次扩张在主动脉缩窄治疗中可有效、安全且成功地进行。

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