BACKGROUND:
Covered
stent implantation for
treatment of
coarctation of the aorta (
CoA) is effective and can prevent aortic wall
injury.
Prospective studies with long-term follow-up, including imaging, are lacking. We
report the acute and long-term outcomes for use of the Large Diameter Advanta V12 covered
stent for
treatment of native and recurrent
CoA.
METHODS:
A prospective, multicenter, nonrandomized study was performed including 70
patients (43
male), median age 17 years, median weight 57.4 kg with
CoA who underwent implantation of the Large Diameter Advanta V12 covered
stent. Annual follow-up for 5 years included
Doppler echocardiography to calculate diastolic velocity systolic velocity ratio.
RESULTS:
CoA diameter increased from 5.6±3.6 to 14.9±3.9 mm (P<0.0001) and the
pressure gradient decreased from 35.8±16.2 to 5.6±7.9 mm Hg (P<0.0001). Preimplantation diastolic velocity systolic velocity of 0.6±0.16 dropped to 0.34±0.13 (P<0.0001) and was maintained at 5 years. Computed
tomography angiograms at 12 months post implantation demonstrated the
stent transverse arch diameter to be
similar, 0.91±0.09 to post
procedure 0.86±0.14. Major adverse vascular events at 30 days and 12 months were 1.4% and 4.3%, respectively. Significant adverse events included three
patients who required
stent implantation to treat infolding. There were no mortalities.
CONCLUSIONS:
The Large Diameter Advanta V12 covered
stent is safe and effective for the
treatment of
CoA with an immediate and sustained reduction of the
pressure gradient over 12 months and 5 years as assessed by preimplantation and post implantation
Doppler echocardiography and 12-month
computed tomography angiography.
