TY - JOUR
T1 - Results of a multimodal approach for the management of aortic coarctation and its complications in adults
AU - Noly, Pierre Emmanuel
AU - Legris-Falardeau, Valéry
AU - Ibrahim, Reda
AU - El-Hamamsy, Ismaïl
AU - Cartier, Raymond
AU - Lamarche, Yoan
AU - Bouchard, Denis
AU - Dorval, Jean François
AU - Poirier, Nancy
AU - Demers, Philippe
N1 - Publisher Copyright:
© The Author 2017.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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. RESULTS: Sixty-three adults were treated for a native coarctation (n = 34), a recurrent coarctation (n = 14) or aneurysmal complication (n = 15). Mean age of the patients was 42 ± 1.7 years. All but 1 patient with native coarctation (33/34, 97%) and recurrent coarctation (13/14, 93%) underwent endovascular repair and 10 (67%) patients with aneurysmal complications were treated surgically. Freedom from the primary composite end point was 94, 84 and 81% at 1, 5 and 10 years, respectively, without difference between the 3 indication groups (P = 0.96). CONCLUSIONS: A tailored management strategy is necessary to provide good results for the treatment of adults with aortic coarctation. Thus, centres that are involved in the care of this complex pathology should be able to propose a multimodal approach, either endovascular or surgical depending on patient's characteristics and anatomic features.
AB - 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. RESULTS: Sixty-three adults were treated for a native coarctation (n = 34), a recurrent coarctation (n = 14) or aneurysmal complication (n = 15). Mean age of the patients was 42 ± 1.7 years. All but 1 patient with native coarctation (33/34, 97%) and recurrent coarctation (13/14, 93%) underwent endovascular repair and 10 (67%) patients with aneurysmal complications were treated surgically. Freedom from the primary composite end point was 94, 84 and 81% at 1, 5 and 10 years, respectively, without difference between the 3 indication groups (P = 0.96). CONCLUSIONS: A tailored management strategy is necessary to provide good results for the treatment of adults with aortic coarctation. Thus, centres that are involved in the care of this complex pathology should be able to propose a multimodal approach, either endovascular or surgical depending on patient's characteristics and anatomic features.
KW - Aortic coarctation
KW - Aortic stenting
KW - Thoracic endovascular repair
UR - http://www.scopus.com/inward/record.url?scp=85037576683&partnerID=8YFLogxK
U2 - 10.1093/icvts/ivx039
DO - 10.1093/icvts/ivx039
M3 - Article
C2 - 28498970
AN - SCOPUS:85037576683
SN - 1569-9293
VL - 25
SP - 335
EP - 342
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 3
ER -