Effectiveness of Stent therapy of Coarctation of Aorta in Reducing systemic blood Pressure

  • Dr Najma Patel, National Institute of Cardiovascular Diseases, Pakistan
  • Prof Kalimuddin Aziz, National Institute of Cardiovascular Diseases
  • Dr Shakeel Qureshi, St.Thomas Hospital.London,United Kingdom, United Kingdom

    • Objective: To assess the effectiveness of Stent therapy (ST) for Coarctation of Aorta (CoA) in reducing Systemic Blood Pressure (BP)

    Method: Follow up(f/u) data after ST was analyzed.37 patients were studied for ST.30 with native and 7 with recurrent CoA .32 had ST,5 were not suitable.26/32 were hypertensive. On Aortograms, discrete CoA was found in 15, long segment in 13 while 4 had near atretic Co A.
    BIB Balloon and CP stent were used. Dilated to the balloon size 2 mm smaller than the diameter of Arch or equal to the diameter of descending aorta .2 with near atresia had hypoplastic proximal segment, so were dilated up to the diameter of proximal segment. All patients had four limbs BP recording preprocedure and then in f/u period. Postdilatation, patients normotensive at rest had exercise test

    Result: Mean gradient across CoA decreased from 55.2mmHg (SDą19.2,range21-90) to 12.3mmHg (SDą12.47,range2-30) p<0.000.
    Predilatation mean SBP was 164.7 mmHg (SDą27.3,range112-210) and mean DBP was 99.5 mmHg (ąSD16.2,range70-120).At mean f/u of 27.5 months, mean SBP was 135.4 mmHg, (SDą18.5,110-165) p<0.002, and mean DBP 83.8mmHg (ąSD 9.6,range70-100) p<0.000.Post dilatation 13 vs. 6 predilataion were normotensive at rest.
    Predilatation 6 were not taking any antihypertensive drugs,12 were taking two and 14 were taking 3. Postdilatation 9 were not taking any medication,10 were taking only one,4/10 were normotensive at rest but showed hypertensive response to exercise ,10 were taking 2 and only 3 were taking 3 drugs .

    Conclusion: We conclude that ST provides long term reduction in systemic hypertension


    Post dilatation 13 were normotensive vs 6 predilataion patients at rest,4/13
    showed hypertensive response to exercise ,therefore taking 0ne drug

    Predilatation 6 were not taking any antihypertensive drugs,12 were taking two and 14 were taking 3 drugs,Postdilatation 9 were not taking any medication, 10 were taking only one,10 were taking 2 ,only 3 were taking 3 drugs

    Post dilatation 13 vs 6 predilataion were normotensive at rest,4/13
    showed hypertensive response to exercise ,therefore taking one drug