Title: Bailout stenting for critical coarctation in premature/critical/complex/early recoarcted neonates
Authors: Gorenflo, Matthias
Boshoff, Derize E
Heying, Ruth
Eyskens, Benedicte
Rega, Filip
Meyns, Bart
Gewillig, Marc # ×
Issue Date: Mar-2010
Publisher: Wiley-Liss
Series Title: Catheterization and Cardiovascular Interventions vol:75 issue:4 pages:553-561
Abstract: Background: Surgical repair of critical coarctation can be problematic in premature, critical, complex, or early postoperative neonates. Objectives: We aimed to review our experience with stent implantation to defer urgent surgery to an elective time. Methods: Fifteen neonates with severe aortic coarctation: five premature-hypotrophic (1,400-2,000 g), six critical and complex cardiac malformation, four early (1 day [0-2 days]; median [range]) after surgical coarctectomy or complex arch reconstruction. Bare coronary stents (diameter 4.0 [3.5-5.0] mm; length 10 [8-16] mm) were used. Stents were removed surgically depending on clinical needs. Results: Adequate aortic flow was obtained in 15 patients. The femoral artery was preserved in 13/15 patients. Two deaths occurred before stent removal and were nonprocedure related. In patients with simple stented coarctation, the stent was removed after 2.8 [0.2-5.0] months. In complex cardiac malformation, stents were finally removed 3.0 [0.2-78] months after implantation. Surgical technique: simple coarctectomy end-to-end in eight, extensive arch patch reconstruction in four. One patient is awaiting stent removal. The final maximum systolic velocity (cw-Doppler) across the aortic arch was 1.7 [1.2-2.5] m/sec. Conclusions: In premature/critical/complex neonates with severe coarctation, bailout stenting followed by early or late surgical coarctectomy appears a promising concept. (c) 2009 Wiley-Liss, Inc.
ISSN: 1522-1946
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Cardiac Surgery
Pediatric Cardiology Section (-)
Cardiovascular Developmental Biology
× corresponding author
# (joint) last author

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