Transcatheter Intervention for Coarctation of the Aorta: A Nordic Population-Based Registry With Long-Term Follow-Up.
catheter intervention
coarctation of Aorta
congenital heart disease
Journal
JACC. Cardiovascular interventions
ISSN: 1876-7605
Titre abrégé: JACC Cardiovasc Interv
Pays: United States
ID NLM: 101467004
Informations de publication
Date de publication:
27 02 2023
27 02 2023
Historique:
received:
21
04
2022
revised:
19
10
2022
accepted:
07
11
2022
entrez:
1
3
2023
pubmed:
2
3
2023
medline:
4
3
2023
Statut:
ppublish
Résumé
Coarctation of the aorta (CoA), a congenital narrowing of the proximal descending thoracic aorta, is a relatively common form of congenital heart disease. Untreated significant CoA has a major impact on morbidity and mortality. In the past 3 decades, transcatheter intervention (TCI) for CoA has evolved as an alternative to surgery. The authors report on all TCIs for CoA performed from 2000 to 2016 in 4 countries covering 25 million inhabitants, with a mean follow-up duration of 6.9 years. During the study period, 683 interventions were performed on 542 patients. The procedural success rate was 88%, with 9% considered partly successful. Complications at the intervention site occurred in 3.5% of interventions and at the access site in 3.5%. There was no in-hospital mortality. During follow-up, TCI for CoA reduced the presence of hypertension significantly from 73% to 34%, but despite this, many patients remained hypertensive and in need of continuous antihypertensive treatment. Moreover, 8% to 9% of patients needed aortic and/or aortic valve surgery during follow-up. TCI for CoA can be performed with a low risk for complications. Lifetime follow-up after TCI for CoA seems warranted.
Sections du résumé
BACKGROUND
Coarctation of the aorta (CoA), a congenital narrowing of the proximal descending thoracic aorta, is a relatively common form of congenital heart disease. Untreated significant CoA has a major impact on morbidity and mortality. In the past 3 decades, transcatheter intervention (TCI) for CoA has evolved as an alternative to surgery.
OBJECTIVES
The authors report on all TCIs for CoA performed from 2000 to 2016 in 4 countries covering 25 million inhabitants, with a mean follow-up duration of 6.9 years.
METHODS
During the study period, 683 interventions were performed on 542 patients.
RESULTS
The procedural success rate was 88%, with 9% considered partly successful. Complications at the intervention site occurred in 3.5% of interventions and at the access site in 3.5%. There was no in-hospital mortality. During follow-up, TCI for CoA reduced the presence of hypertension significantly from 73% to 34%, but despite this, many patients remained hypertensive and in need of continuous antihypertensive treatment. Moreover, 8% to 9% of patients needed aortic and/or aortic valve surgery during follow-up.
CONCLUSIONS
TCI for CoA can be performed with a low risk for complications. Lifetime follow-up after TCI for CoA seems warranted.
Identifiants
pubmed: 36858664
pii: S1936-8798(22)02098-2
doi: 10.1016/j.jcin.2022.11.007
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
444-453Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures This work was funded by the Swedish state under the ALF agreement (grant 236611) and the Swedish Heart-Lung Foundation (grant 20180644) and Forskningsstiftelsen vid kardiologiska sektionen SU/Ostra Hospital. This study received no financial or other industry support. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.