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Late Outcomes of Transcatheter Coarctation Intervention in Infants with Biventricular Anatomy

Abstract

Determine outcomes of catheter intervention for aortic coarctation in infants. Aortic coarctation in infants following surgical repair and in high surgical risk native cases remains a challenging problem. Catheter intervention is an alternative to surgical intervention. Single-center, chart review of infants with biventricular anatomy who underwent coarctation stent placement or balloon angioplasty between 04/2004 and 04/2020. Outcomes of interest included change in aortic lumen diameter, peak gradient, number of re-interventions, time to re-intervention, and adverse events. Thirty-four patients were included in analysis, of those 16 underwent stent placement. Patients’ mean age was 4.0 ± 3.0 months and weight of 5.3 ± 1.9 kg. Follow-up interval was 5.4 ± 5.1 years (0.2–16.1 years). Twelve (35%) patients underwent procedure due to ventricular dysfunction; the rest were for high resting gradient. Coarctation diameter increased from 2.4 ± 1.0 to 4.5 ± 1.3 (p < 0.01) and gradient decreased from 32.0 ± 18.4 mmHg to 9.2 ± 8.8 mmHg (p < 0.01). Thirteen (81%) of the stented patients required at least one re-intervention, at an average of 1.7 ± 3.2 years from the index procedure. Five (28%) of those undergoing balloon angioplasty required repeat intervention. There was no mortality due to the procedure and one late mortality. One patient had a serious procedural adverse event. On follow-up, 12 (35%) were on anti-hypertensive medications. Catheter intervention, including stent placement, for aortic coarctation in infants is feasible with an acceptable adverse event profile. Repeat interventions are common.

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No funding was received for conducting this study. The authors have no relevant financial or non-financial interests to disclose.

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis was performed by JK, BM, TJ, AR, and TJ. The first and revised drafts of the manuscript were written by JK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Joshua D. Kurtz.

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Kurtz, J.D., Rubio, A.E., Johnston, T.A. et al. Late Outcomes of Transcatheter Coarctation Intervention in Infants with Biventricular Anatomy. Pediatr Cardiol 43, 1438–1443 (2022). https://doi.org/10.1007/s00246-022-02865-5

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  • DOI: https://doi.org/10.1007/s00246-022-02865-5

Keywords

  • Aortic coarctation
  • Congenital heart disease
  • Endovascular procedures
  • Congenital heart surgery