[Efficacy of angioplasty of native coarctations of the aorta of the big infant and of the adult with systematic endoprosthesis implantation].
The angioplasty of native coarcatations of the aorta remains a controversial treatment due to recurrences and the potential risk of aneurysm or of descending aorta dissection during catheterization. The interest of a systematic implantation of an endoprothesis is poorly documented. We report our experience in a small series of 3 patients aged from 7, 28 to 52 years at the moment of the angioplasty of their native aortic coarctation. In all the three cases it corresponded to a "membranous" type, localized a the level of the isthmus without hypoplasia of the aortic arch. All presented a refractory hypertension. One patient presented an intermittent claudication related to a low perfusion of lower limbs. The angioplasty was performed with BIB balloon, associated at the same time with the implantation of a Palmaz P308 stent in two cases and Genesis PG2910P in the last patient. The efficacy was immediate in all the 3 cases with stopping antihypertensive drugs at the very day of the procedure. The immediate results were complicated by a bilateral hematoma of the scarpa in a context of excessive anticoagulation in one patient requiring blood tranfusion. After a follow-up of one, 12 and 21 months, all the 3 patients are asymptomatic without any significant residual hypertension. The control scan of the infant confirmed the absence of re-coarctation. In conclusion, the angioplasty followed by systematic implantation of an endoprosthesis is a safe and effective technique for treating simple forms of native coarctations of the aortic isthmus. It can be proposed as a first line treatment for big infants and adults affected by localized types.
Fraisse
A
A
Cardiologie pédiatrique, département de cardiologie, hôpital de la Timone, 13005 Marseille. afraisse@ap-hm.fr
Amabile
N
N
Errera
J
J
Aubert
F
F
Chetaille
P
P
Kreitmann
B
B
Metras
D
D
Durieux
O
O
Bonnet
J L
JL
Djiane
P
P
D000328:Adult; D017130:Angioplasty; D001017:Aortic Coarctation / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged