Heart function and remodeling after successful stenting of coarctation of aorta in children

Abstract

Background: There are not enough studies investigating the results of stent implantation for Coarctation of the Aorta (COA) in the pediatric age group. Objective: This investigation evaluated the heart function and remodeling after successful COA stenting in children. Materials and method: The study was performed from April 2017 till April 2020 on patients with COA (<18 years old) referring to Namazi, Faghihi and Kowsar hospital, tertiary centers from 2010 till 2017. Demographic data, clinical examination results and echocardiographic parameters were reported. All statistical analyses were performed with the SPSS version 22. Results: Fourty-two children were enrolled in this study. Mean age at the time of stenting was 10.44 ± 3.93, and mean follow-up was 3.57 ± 3.40 years (1-6 years). 24 patients (77.8%) were male. Measurement of thoracic aorta diameters revealed that mean transverse arch, isthmus and distal arch diameter with its z-scores were 1.40 ± 0.43 (Z score = -1.50 ± 1.33), 1.17 ± 0.28 (Z score =-0.72 ± 1.43) and 1.21 ± 0.42 (Z score = -0.94 ± 3.46). Mean systolic blood pressure at the follow-up time was 122.5 ± 17.70 mmHg, and mean diastolic blood pressure was 81.25 ± 9.57. Significant correlation existed between IVSd value and transverse arch diameter (P=0.023, r=0.564), and also distal arch diameter (P=0.039, r=0.521). There was also a significant correlation between LVIDd and measured transverse (P=0.007, r=0.648) and distal arch diameter (P=0.034, r=0.521). Instead, the correlation between E/A value and IVSs (P=0.023) and IVSs Z score (P=0.044, r=0.480) was significant. There was a significant correlation between LVPWd parameter and Doppler measurement of the gradient at the stent site (P=0.024, r=0.621) measured at the time of follow-up. Conclusion: Based on the results, endovascular stenting to treat CoA appears to be a safe and efficient method. LV hypertrophy and diastolic dysfunction did not regressin a significant number of patients after successful stenting. Keywords: aortic coarctation; child; heart; stents.