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Coarctation of the aorta: nonsurgical treatment using stent implantation
Coarctation of the aorta (CoA) accounts for 5%-8% of all congenital heart defects. If left untreated, most patients with significant CoA will have varying degrees of morbidity (e.g. hypertension, stroke, collateral formation and ventricular hypertrophy), possibly even mortality. Traditionally, treat...
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| Published in: | Singapore medical journal 2014-06, Vol.55 (6), p.302-304 |
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| creator | Ang, H L Lim, C W Hia, C Yip, J Quek, S C |
| description | Coarctation of the aorta (CoA) accounts for 5%-8% of all congenital heart defects. If left untreated, most patients with significant CoA will have varying degrees of morbidity (e.g. hypertension, stroke, collateral formation and ventricular hypertrophy), possibly even mortality. Traditionally, treatment for this condition is surgical. Herein, we report stenting during catheterisation as an alternative nonsurgical treatment option for patients with CoA, and present the treatment outcomes of patients who underwent this treatment option.
We retrospectively reviewed four patients (2 men and 2 women; age range 20-41 years) who underwent CoA stenting under general anaesthesia for the treatment of native CoA or restenosis of CoA at our institution. Three patients had a 40-mm Palmaz stent inserted, while one had a 39-mm Cheatham-Platinum covered stent inserted. Angiography and measurement of pressure gradients were performed before and after stent implantation to ensure good treatment outcomes.
The patients' treatment outcomes were good, with a significant reduction in pressure gradients across the narrowed segments. Angiography showed relief of CoA. The patients were followed up for 1-3 years, during which no complications were noted.
This is the first reported series in Singapore on the nonsurgical treatment of CoAs in adult patients using stents during interventional cardiac catheterisation. This less invasive procedure may lead to a new paradigm shift with regard to the treatment of CoA. |
| doi_str_mv | 10.11622/smedj.2014080 |
| format | article |
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We retrospectively reviewed four patients (2 men and 2 women; age range 20-41 years) who underwent CoA stenting under general anaesthesia for the treatment of native CoA or restenosis of CoA at our institution. Three patients had a 40-mm Palmaz stent inserted, while one had a 39-mm Cheatham-Platinum covered stent inserted. Angiography and measurement of pressure gradients were performed before and after stent implantation to ensure good treatment outcomes.
The patients' treatment outcomes were good, with a significant reduction in pressure gradients across the narrowed segments. Angiography showed relief of CoA. The patients were followed up for 1-3 years, during which no complications were noted.
This is the first reported series in Singapore on the nonsurgical treatment of CoAs in adult patients using stents during interventional cardiac catheterisation. This less invasive procedure may lead to a new paradigm shift with regard to the treatment of CoA.</description><identifier>ISSN: 0037-5675</identifier><identifier>DOI: 10.11622/smedj.2014080</identifier><identifier>PMID: 25017404</identifier><language>eng</language><publisher>Singapore: Singapore Medical Association</publisher><subject>Adult ; Angiography ; Aortic Coarctation - therapy ; Cardiac Catheterization ; Female ; Humans ; Male ; Original ; Pressure ; Retrospective Studies ; Singapore ; Stents ; Treatment Outcome ; Young Adult</subject><ispartof>Singapore medical journal, 2014-06, Vol.55 (6), p.302-304</ispartof><rights>Copyright: © Singapore Medical Association 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-20ee39e85e0f9ab008a58b475f01a3c685dc313c7d70a28fedb705ee78ffb1c53</citedby><cites>FETCH-LOGICAL-c357t-20ee39e85e0f9ab008a58b475f01a3c685dc313c7d70a28fedb705ee78ffb1c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294052/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294052/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25017404$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ang, H L</creatorcontrib><creatorcontrib>Lim, C W</creatorcontrib><creatorcontrib>Hia, C</creatorcontrib><creatorcontrib>Yip, J</creatorcontrib><creatorcontrib>Quek, S C</creatorcontrib><title>Coarctation of the aorta: nonsurgical treatment using stent implantation</title><title>Singapore medical journal</title><addtitle>Singapore Med J</addtitle><description>Coarctation of the aorta (CoA) accounts for 5%-8% of all congenital heart defects. If left untreated, most patients with significant CoA will have varying degrees of morbidity (e.g. hypertension, stroke, collateral formation and ventricular hypertrophy), possibly even mortality. Traditionally, treatment for this condition is surgical. Herein, we report stenting during catheterisation as an alternative nonsurgical treatment option for patients with CoA, and present the treatment outcomes of patients who underwent this treatment option.
We retrospectively reviewed four patients (2 men and 2 women; age range 20-41 years) who underwent CoA stenting under general anaesthesia for the treatment of native CoA or restenosis of CoA at our institution. Three patients had a 40-mm Palmaz stent inserted, while one had a 39-mm Cheatham-Platinum covered stent inserted. Angiography and measurement of pressure gradients were performed before and after stent implantation to ensure good treatment outcomes.
The patients' treatment outcomes were good, with a significant reduction in pressure gradients across the narrowed segments. Angiography showed relief of CoA. The patients were followed up for 1-3 years, during which no complications were noted.
This is the first reported series in Singapore on the nonsurgical treatment of CoAs in adult patients using stents during interventional cardiac catheterisation. This less invasive procedure may lead to a new paradigm shift with regard to the treatment of CoA.</description><subject>Adult</subject><subject>Angiography</subject><subject>Aortic Coarctation - therapy</subject><subject>Cardiac Catheterization</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Original</subject><subject>Pressure</subject><subject>Retrospective Studies</subject><subject>Singapore</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0037-5675</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNpVkEFPwzAMhXMAsTG4ckT9Ax1O0iwZByRUAUOaxAXOkZsmW6e2mZIMiX9P2cYEJ1uy3_PzR8gNhSmlM8buYmfrzZQBLUDBGRkDcJmLmRQjchnjBoBJUOqCjJgAKgsoxmRRegwmYWp8n3mXpbXN0IeE91nv-7gLq8Zgm6VgMXW2T9kuNv0qi-mnb7pti_1BfEXOHbbRXh_rhHw8P72Xi3z59vJaPi5zw4VMOQNr-dwqYcHNsQJQKFRVSOGAIjczJWrDKTeyloBMOVtXEoS1UjlXUSP4hDwcfLe7anjXDDkCtnobmg7Dl_bY6P-Tvlnrlf_UBZsXINhgMD0YmOBjDNadtBT0nqPec9RHjoPg9u_F0_ovRP4NQiN0OA</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Ang, H L</creator><creator>Lim, C W</creator><creator>Hia, C</creator><creator>Yip, J</creator><creator>Quek, S C</creator><general>Singapore Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20140601</creationdate><title>Coarctation of the aorta: nonsurgical treatment using stent implantation</title><author>Ang, H L ; Lim, C W ; Hia, C ; Yip, J ; Quek, S C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-20ee39e85e0f9ab008a58b475f01a3c685dc313c7d70a28fedb705ee78ffb1c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Angiography</topic><topic>Aortic Coarctation - therapy</topic><topic>Cardiac Catheterization</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Original</topic><topic>Pressure</topic><topic>Retrospective Studies</topic><topic>Singapore</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ang, H L</creatorcontrib><creatorcontrib>Lim, C W</creatorcontrib><creatorcontrib>Hia, C</creatorcontrib><creatorcontrib>Yip, J</creatorcontrib><creatorcontrib>Quek, S C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Singapore medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ang, H L</au><au>Lim, C W</au><au>Hia, C</au><au>Yip, J</au><au>Quek, S C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coarctation of the aorta: nonsurgical treatment using stent implantation</atitle><jtitle>Singapore medical journal</jtitle><addtitle>Singapore Med J</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>55</volume><issue>6</issue><spage>302</spage><epage>304</epage><pages>302-304</pages><issn>0037-5675</issn><abstract>Coarctation of the aorta (CoA) accounts for 5%-8% of all congenital heart defects. If left untreated, most patients with significant CoA will have varying degrees of morbidity (e.g. hypertension, stroke, collateral formation and ventricular hypertrophy), possibly even mortality. Traditionally, treatment for this condition is surgical. Herein, we report stenting during catheterisation as an alternative nonsurgical treatment option for patients with CoA, and present the treatment outcomes of patients who underwent this treatment option.
We retrospectively reviewed four patients (2 men and 2 women; age range 20-41 years) who underwent CoA stenting under general anaesthesia for the treatment of native CoA or restenosis of CoA at our institution. Three patients had a 40-mm Palmaz stent inserted, while one had a 39-mm Cheatham-Platinum covered stent inserted. Angiography and measurement of pressure gradients were performed before and after stent implantation to ensure good treatment outcomes.
The patients' treatment outcomes were good, with a significant reduction in pressure gradients across the narrowed segments. Angiography showed relief of CoA. The patients were followed up for 1-3 years, during which no complications were noted.
This is the first reported series in Singapore on the nonsurgical treatment of CoAs in adult patients using stents during interventional cardiac catheterisation. This less invasive procedure may lead to a new paradigm shift with regard to the treatment of CoA.</abstract><cop>Singapore</cop><pub>Singapore Medical Association</pub><pmid>25017404</pmid><doi>10.11622/smedj.2014080</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Singapore medical journal, 2014-06, Vol.55 (6), p.302-304 |
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| language | eng |
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| source | PubMed Central |
| subjects | Adult Angiography Aortic Coarctation - therapy Cardiac Catheterization Female Humans Male Original Pressure Retrospective Studies Singapore Stents Treatment Outcome Young Adult |
| title | Coarctation of the aorta: nonsurgical treatment using stent implantation |
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