Demir İbrahim Halil, Kardas Murat, Yucel İlker Kemal, Yekeler Rukiye İrem, Bulut Mustafa Orhan, Hekim Yılmaz Emine, Sürücü Murat, Epçaçan Serdar, Celebi Ahmet
Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye.
Department of Pediatric Cardiology, Van Training and Research Hospital, Van, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Apr 30;32(2):151-161. doi: 10.5606/tgkdc.dergisi.2024.25931. eCollection 2024 Apr.
This study aimed to investigate the safety and efficacy of transverse aortic arch stenting and evaluate the course of hypertension and the act of arch stenting on systemic hypertension.
The transverse aortic arch stenting procedures between January 2007 and May 2023 were retrospectively analyzed. Detailed procedure information, technical aspects, pressure measurements, angiographic data, balloons and stents used, complications, and immediate results were examined. Early and mid-term results were assessed.
Eighteen patients (10 males and 8 females; mean age: 14.5±5.3 years; range, 4 to 23 years) were included in the study, all of whom were hypertensive before the procedure. The mean weight was 56.8±19.6 kg. In seven patients, the stent struts had to be dilated due to the stent causing jailing at the entrance of nearby arch vessels. After stenting, there was a significant increase in arch diameter and a decrease in ascending aorta pressure and the pressure gradient across the aorta. There were no early mortality or major complications. Late migration of the stent was observed in one patient. Three patients became normotensive immediately after the intervention, and five became drug-free during the follow-up. The requirement for dual antihypertensive therapy was significantly reduced.
Residual transverse arch lesions may contribute to the persistence of systemic hypertension after coarctation treatment. Transverse arch stent implantation can be performed safely with favorable outcomes, facilitating better blood pressure control. However, it should be noted that these patients remain at risk for lifelong hypertension and should be closely monitored in this regard.
本研究旨在探讨经胸主动脉弓支架置入术的安全性和有效性，并评估高血压病程以及主动脉弓支架置入术对全身性高血压的作用。
回顾性分析2007年1月至2023年5月期间的经胸主动脉弓支架置入手术。检查详细的手术信息、技术细节、压力测量、血管造影数据、使用的球囊和支架、并发症及即刻结果。评估早期和中期结果。
18例患者（男10例，女8例；平均年龄：14.5±5.3岁；范围4至23岁）纳入研究，所有患者术前均患有高血压。平均体重为56.8±19.6千克。7例患者因支架在附近主动脉弓血管入口处导致卡压，不得不对支架撑条进行扩张。支架置入后，主动脉弓直径显著增加，升主动脉压力及主动脉跨压梯度降低。无早期死亡或严重并发症。1例患者观察到支架晚期移位。3例患者干预后即刻血压恢复正常，5例患者在随访期间停用降压药物。联合降压治疗的需求显著减少。
残余的主动脉弓病变可能导致缩窄治疗后全身性高血压持续存在。经胸主动脉弓支架置入术可安全进行，效果良好，有助于更好地控制血压。然而，应注意这些患者仍有终身高血压风险，在这方面应密切监测。
