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Implantation of stents for treatment of recurrent and native coarctation in children weighing less than 20 kilograms

Published online by Cambridge University Press:  31 October 2007

Rainer Schaeffler ,
Tanja Kolax ,
Carola Hesse  and
Matthias Peuster
Rainer Schaeffler
Affiliation:
Clinic for Congenital Heart Defects, Heart- and Diabetes-Center Nordrhein Westfalen, Bad Oeynhausen, Germany
Tanja Kolax
Affiliation:
Department for Pediatric Cardiology and Pediatric Intensive Care, University of Rostock, Germany
Carola Hesse
Affiliation:
Department for Pediatric Cardiology and Pediatric Intensive Care, University of Rostock, Germany
Matthias Peuster*
Affiliation:
Department for Pediatric Cardiology and Pediatric Intensive Care, University of Rostock, Germany
*
Correspondence to: Matthias Peuster MD PhD, Department for Pediatric Cardiology and Pediatric Intensive Care, University of Rostock, Rembrandtstr. 16/17, 18055 Rostock, Germany. Tel: +49 381 494 7201; Fax: +49 381 494 7202; E-mail: matthias.peuster@med.uni-rostock.de
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Abstract

We report our experience with implantation of stents for treatment of recurrent and native aortic coarctation in children weighing less than 20 kilograms. We treated 9 such patients between March, 2003, and January, 2006.

In 2 patients, the coarctation had not previously been treated, while in 7 it had recurred after surgery. The patients had a median weight of 14 kilograms, with a range from 5.5 to 19 kilograms. Balloon dilation was needed in 1 patient before the stent was implanted.

We used Palmaz Genesis XD stents in 7 patients, these having lengths from 19 to 29 millimetres, 1 Palmaz Genesis 124P stent, and 1 peripheral JoStent with a diameter of 6 to 12 millimetres. Implantation was effective in all patients. Immediately after implantation, the mean peak systolic gradient decreased from 30 millimetres of mercury, the range having been 15 to 50 mm, to 3 millimetres of mercury, with the final range from zero to 10 mm. There were no complications, with no observations of aneurysms, dissections, or dislocated stents. In 1 patient, the peripheral pulse was weak secondary to arterial access, but treatment with Heparin led to complete resolution. It was necessary to re-dilate the stent in another patient, while 2 others are scheduled for redilation because of growth-related restenosis. Our findings suggest that implantation of stents can produce excellent relief of the gradient produced by recurrent or native coarctation.

The process is safe and effective in patients weighing less than 20 kilograms.

Keywords

Interventional paediatric catheterizationinfantstreatment
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 6 , December 2007 , pp. 617 - 622
Copyright
Copyright © Cambridge University Press 2007

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