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Coarctation Repair

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https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#1
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28622942/arterial-hypertension-after-coarctation-repair-in-long-term-follow-up-coafu-predictive-value-of-clinical-variables
#2
Pinar Bambul Heck, Jelena Pabst von Ohain, Harald Kaemmerer, Peter Ewert, Alfred Hager
No abstract text is available yet for this article.
May 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28617686/imaging-adult-patients-with-coarctation-of-the-aorta
#3
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To provide an overview of current recommendations and techniques used to image coarctations of the aorta. RECENT FINDINGS: Imaging of coarctation of the aorta in adults is moving away from conventional techniques such as echocardiography and invasive angiography. Echocardiography may assist in making the diagnosis but is limited in its ability to quantify the severity of coarctations. Current guidelines recommend that every patient with a coarctation must undergo a computed tomography (CT) or MRI scan for accurate delineation of morphology...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28608147/coarctation-index-predicts-recurrent-aortic-arch-obstruction-following-surgical-repair-of-coarctation-of-the-aorta-in-infants
#4
Gregory Adamson, Tara Karamlou, Phillip Moore, Luz Natal-Hernandez, Sarah Tabbutt, Shabnam Peyvandi
Recurrent aortic arch obstruction (RAAO) remains a major cause of morbidity following surgical neonatal repair of coarctation of the aorta (CoA). Elucidating predictors of RAAO can identify high-risk patients and guide postoperative management. The Coarctation index (CoA-I), defined as the ratio of the diameter of the narrowest aortic arch segment to the diameter of the descending aorta, has been used to help diagnose RAAO in neonates following the Norwood Procedure. We sought to assess the predictive value of the CoA-I on RAAO after CoA repair in infants with biventricular circulation...
June 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28595675/is-the-medical-treatment-for-arterial-hypertension-after-primary-aortic-coarctation-repair-related-to-age-at-surgery-a-retrospective-cohort-study
#5
Peter J Lillitos, Mohamed S Nassar, Shane M Tibby, Joy Simmonds, Caner Salih, Conal Austin, David Anderson, Thomas Krasemann
BACKGROUND: Hypertension following primary coarctation repair affects up to a third of subjects. A number of studies suggest that future hypertension risk is reduced if primary repair is performed at a younger age. OBJECTIVES: The objective of this study was to evaluate the risk of future medical treatment for hypertension depending on age of primary coarctation repair. METHODS: This study was carried out at a tertiary paediatric cardiology referral centre...
June 9, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28580660/long-term-outcomes-after-aortic-coarctation-repair-in-maltese-patients-a-population-based-study
#6
Maryanne Caruana, Victor Grech
OBJECTIVES: To investigate survival and freedom from reintervention after aortic coarctation repair in Maltese patients and to compare cardiovascular mortality in coarctation repair survivors with that in the general population. DESIGN: All 72 aortic coarctation patients with any type of repair, born by end-1997 and logged in the local database were included. Trends in timing and type of repair were determined by comparing patients born before and after 1985. Kaplan-Meier analyses of survival and reintervention-free survival were performed on the 59 repair survivors with complete follow-up data (mean follow-up 26...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28575303/are-more-extensive-procedures-warranted-at-the-time-of-aortic-arch-reoperation-%C3%A2
#7
Jeremy S Y Wong, Melissa G Y Lee, Johann Brink, Igor E Konstantinov, Christian P Brizard, Yves d'Udekem
OBJECTIVES: To determine the early and late outcomes of patients undergoing aortic arch reoperations. METHODS: The follow-up of 70 patients undergoing a second arch operation (excluding univentricular physiology) between 1979 and 2015 was reviewed. Median age at initial arch operation and second operation was 9 days (interquartile range: 5-35) and 10 months (interquartile range: 3-64), respectively. The most common indication for initial arch operation was coarctation in 79% (55/70)...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28554563/left-ventricular-fibrosis-and-systolic-hypertension-persist-in-a-repaired-aortic-coarctation-model
#8
Jie Liu, Douglas Drak, Anish Krishnan, Sing-Young Chen, Carla Canniffe, Shisan Bao, Gareth Denyer, David S Celermajer
BACKGROUND: Despite successful repair in early life, patients with coarctation of the aorta (CoA) are predisposed to several cardiovascular complications in later life related to systemic hypertension or left ventricular (LV) dysfunction, or both, the pathogenesis of which is unclear. METHODS: Three-week-old Sprague-Dawley rats underwent transverse aortic constriction (TAC) or a sham operation, with release of the constriction 3 weeks later. Twenty-five weeks after the repair operation, animals underwent hemodynamic assessment, LV gene profiling, and histologic analysis...
May 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28547126/endovascular-management-of-native-postcoarctation-thoracic-aortic-aneurysms
#9
Ziheng Wu, Xiangtao Zheng, Xin Fang, Yangyan He, Donglin Li, Chengfei Zheng, Hongkun Zhang
PURPOSE: Postcoarctation thoracic aortic aneurysm formation is one of the most serious complications for coarctation of aorta. Open surgery to repair these aneurysms is associated with high morbidity and mortality. Endovascular therapy is an attractive alternative to open surgery. We have studied the efficacy and safety of endovascular therapy for postcoarctation thoracic aortic aneurysms, and will share our findings and experience through this document. METHODS: The data was retrospectively collected on consecutive patients who were presented with postcoarctation thoracic aortic aneurysms at our medical center...
May 25, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28545853/elevated-sympathetic-activity-endothelial-dysfunction-and-late-hypertension-after-repair-of-coarctation-of-the-aorta
#10
Melissa G Y Lee, Robyn A Hemmes, Jonathan Mynard, Elisabeth Lambert, Geoffrey A Head, Michael M H Cheung, Igor E Konstantinov, Christian P Brizard, Gavin Lambert, Yves d'Udekem
BACKGROUND: There is a high prevalence of late hypertension after coarctation repair. The relative contribution of elevated sympathetic tone and endothelial dysfunction to its development is unknown. This study aims to investigate the neural profile of coarctation patients including muscle sympathetic nerve activity testing to directly measure sympathetic nervous activity. METHODS: Twenty-three patients aged ≥18years with a coarctation repair underwent measurements of clinic and 24-h blood pressures, muscle sympathetic nerve activity, sympathetic and cardiac baroreflex functions, digital endothelial function, and ambulatory arterial stiffness index...
May 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28523342/exercise-capacity-before-and-after-stent-placement-for-coarctation-of-the-aorta-a-single-center-case-series
#11
Brandon D Morrical, Jason H Anderson, Nathaniel W Taggart
Over the last 15 years, stent placement has become a viable and safe alternative to surgical repair for native and recurrent coarctation of the aorta. Although patients with coarctation of the aorta often have lower exercise tolerance, there is no published data regarding the effect of coarctation stenting on exercise capacity. We aimed to determine the effect of coarctation stent placement on exercise capacity. We conducted a retrospective chart review of all patients who underwent stent placement for native or recurrent coarctation of the aorta at our institution from January 2000 to October 2012...
May 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28520538/treatment-strategies-for-paradoxical-hypertension-following-surgical-correction-of-coarctation-of-the-aorta-in-children
#12
Peter P Roeleveld, Eline G Zwijsen
BACKGROUND: Paradoxical hypertension after repair of coarctation of the aorta is a well-known phenomenon. The pathogenesis involves the activation of the sympathetic nervous system (first phase) and renin-angiotensin system (second phase). Only a limited number of different treatment strategies have been published in the literature, without any comparative studies. METHODS: Our aim was to describe the current international practice variation surrounding pharmacological treatment currently being employed to treat paradoxical hypertension following the repair of coarctation of the aorta in children...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28508920/chronic-low-dose-prostaglandin-and-neonatal-heart-block
#13
Safwat A Aly, Sawsan M Awad, Ra-Id Abdulla, Suhaib Kazmouz, Hoang H Nguyen
Long-term prostaglandin use is commonly associated with side effects such as cortical proliferation of the bones, hypertrophic pyloric stenosis, and soft tissue swelling of the extremities. We report a neonate with critical coarctation of the aorta, who developed second and third degree atrioventricular blocks associated with prolonged prostaglandin E1 (PGE1) infusion. Interestingly, these conduction blocks only occurred at low PGE1 dose. The rhythm disturbances resolved promptly with the discontinuation of PGE1 following surgical repair...
May 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28501658/hybridizing-the-sandwich-and-chimney-techniques-in-the-endovascular-repair-of-coarctation-of-the-aortic-arch-and-postcoarctation-ectasia-concomitant-with-a-left-subclavian-artery-aneurysm
#14
Mingguang Zhang, Hao Nie, Xinyu Gui, Jiang Shao, Bao Liu, Yongjun Li, Changwei Liu, Yuehong Zheng
Coarctation of aorta is a rare congenital malformation and is usually accompanied by other cardiac or vascular lesions. In this case we describe a 51-year-old patient presented with coarctation of the aortic arch and postcoarctation ectasia concomitant with a left subclavian artery aneurysm. Endovascular therapy included the deployment of an inverted wedge-shaped covered stent inserted by a long "chimney" stent and another cylinder-covered stent, forming a "sandwich"-like configuration. The symptoms were alleviated after surgery, and no perioperative or stent-graft-related complications were observed at a 2-year follow-up...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28498970/results-of-a-multimodal-approach-for-the-management-of-aortic-coarctation-and-its-complications-in-adults
#15
Pierre-Emmanuel Noly, Valéry Legris-Falardeau, Reda Ibrahim, Ismaïl El-Hamamsy, Raymond Cartier, Yoan Lamarche, Denis Bouchard, Jean-François Dorval, Nancy Poirier, Philippe Demers
OBJECTIVES: We aimed to assess the results of various tailored management strategies for adults with coarctation in our centre. METHODS: : We reviewed all adults patients treated for aortic caorctation between January 2000 and December 2015 in our institution. The primary end point was a composite of death, perioperative stroke, paraplegia, need for unplanned reoperation or occurrence of pseudoaneurysm during the follow-up. The mean follow-up was 82 ± 5 months...
May 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28498910/extra-anatomical-bypass-in-complex-and-recurrent-aortic-coarctation-and-hypoplastic-arch%C3%A2
#16
Eva Maria Delmo Walter, Mariano Francisco Del Maria Javier, Roland Hetzer
OBJECTIVES: Our goal was to report the selection schemes, technical variations and long-term outcome of extra-anatomical bypass to correct complex, recurrent aortic coarctation and hypoplastic aortic arch. METHODS: Between 1989 and 2012, 53 patients (mean age 13.2 ± 4.3, median 11.6, range 9-23 years) with complex aortic coarctation ( n  = 33; long-segment hypoplastic aortic arch in 15), recurrent coarctation ( n  = 20; anastomosic pseudoaneurysm in 10), underwent correction using extra-anatomical bypass, either with ( n  = 18: femoral bypass = 13, left heart bypass = 5) or without ( n  = 35) extracorporeal circulation via a left lateral thoracotomy ( n = 48) and combined median sternotomy and median laparotomy ( n  = 5)...
May 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28496085/-graft-pseudoaneurysm-after-ascending-to-abdominal-aorta-bypass-for-atypical-coarctation-due-to-aortitis-syndrome-report-of-a-case
#17
Masashi Yada, Kazuo Yamanaka, Senri Miwa, Keiichi Hirose, Hisashi Sakaguchi, Yukiyo Yoshida, Youhei Onga, Yuichi Tara
We present a case of a 44-year-old woman, with pseudoaneurysm formation at the middle of the prosthetic graft, 60 mm in diameter. She had been diagnosed with atypical coarctation due to aortitis 27 years before, and had undergone a bypass operation with 14 mm-diameter Cooley double velour graft from the ascending aorta to the abdominal aorta. This time, endovascular aortic repair was performed to prevent rupture of the pseudoaneurysm. Though a knitted Dacron graft has a risk of psuedaneurysm formation long patency could be obtained when used in ascending aorta-abdominal aorta bypass...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28479463/case-report-an-innovative-endovascular-technique-for-repair-of-descending-thoracic-aortic-aneurysm-following-an-open-coarctation-repair
#18
Pouria Parsa, John Eidt, Anthony Rios, Dennis Gable, Javier Vasquez
It was once postulated that open surgical repair of coarctation of the aorta during childhood patients was cured. However, long-term follow-up has been significant for late problems such as an aneurysm. The incidence of such aneurysm after open surgical coarctation repair is 11-24%. If such an aneurysm is left untreated, patients are at a high risk of morbidity and mortality. Prior to the endovascular era, patients would require a redo open repair which in itself is a highly morbid operation. Currently, thoracic endovascular aortic repair (TEVAR) has been reported as a feasible and safe alternative to open surgical reprocedures in this context...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28466610/neonatal-cardiac-surgery-in-the-new-era-lessons-learned-from-1000-consecutive-cases
#19
Gabriel Amir, Georgy Frenkel, Elchanan Bruckheimer, Alexander Lowenthal, Amichay Rotstein, Jacob Katz, Yelena Zeitlin, Ofer Schiller, Einat Birk
BACKGROUND: neonatal cardiac surgery has evolved over the last 50 years with a large percentage of the patients achieving complete physiological repair in the neonatal period. The remaining patients achieve staged palliation with an increasing amount of success. OBJECTIVES: To report our experience with 1000 neonatal cardiac surgical procedures performed in the last 10 years. METHODS: We conducted a retrospective analysis of surgical outcome in all neonatal patients who underwent cardiac surgery between January 2007 and July 2016 at Schneider Children's Medical Center of Israel...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28461801/a-rare-case-of-vascular-ring-and-coarctation-of-the-aorta-in-association-with-charge-syndrome
#20
Jonathan B Wagner, Joshua Q Knowlton, Peter Pastuszko, Sanket S Shah
A male neonate presented with CHARGE syndrome, a multiorgan genetic disorder involving the Coloboma of the eyes, congenital Heart defects, nasal choanal Atresia, growth and development Retardation, Genitourinary disorders, and Ear anomalies and deafness. Moreover, he had a rare case of vascular ring-consisting of a right aortic arch with retroesophageal brachiocephalic artery-combined with coarctation of the mid-aortic arch. He underwent both vascular ring and aortic arch repair at our institution. To our knowledge, this is the 4th documented case of this exceedingly rare type of aortic arch anomaly combined with aortic arch obstruction...
April 2017: Texas Heart Institute Journal
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