Midaortic syndrome: 30 years of experience with medical, endovascular and surgical management.
Pediatr Nephrol
; 28(10): 2023-33, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-23775038
ABSTRACT
BACKGROUND:
Midaortic syndrome is often associated with refractory hypertension. The aim of our study was to better understand the short- and medium-term outcomes in this patient population utilizing a multidisciplinary management approach.METHODS:
We conducted a review of patients with midaortic syndrome treated at our institution over the past 30 years.RESULTS:
Fifty-three patients presented at a median age of 6.7 years (birth to 28.7 years). Thirty-five patients (66 %) underwent invasive management (percutaneous techniques 21; surgical techniques 5; both 9). Percutaneous interventions were acutely successful in decreasing the gradient across the obstruction and degree of luminal stenosis. However, freedom from reintervention was 58 % at 1 year and 33 % at 5 years. Freedom from reintervention after a surgical procedure was longer 83 % at 1 year and 72 % at 10 years. At the most recent follow-up, the majority of patients (69 %) were normotensive. The median duration between time of presentation and achievement of blood pressure control was 5.7 (0.4-21.1) years. The median number of anti-hypertensive medications was 1 (0-5).CONCLUSIONS:
A multidisciplinary management strategy which couples comprehensive medical management with catheter-based and surgical interventions can lead to adequate blood pressure control and preservation of end-organ function in patients with midaortic syndrome.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Aorta Abdominal
/
Enfermedades de la Aorta
/
Arteriopatías Oclusivas
/
Procedimientos Quirúrgicos Vasculares
/
Procedimientos Endovasculares
/
Hipertensión
/
Antihipertensivos
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Pediatr Nephrol
Asunto de la revista:
NEFROLOGIA
/
PEDIATRIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos