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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2008 Agosto;49(4):483-7
Endovascular surgery by means of a Talent endoprosthesis implant in adult patients with thoracic aorta coarctation
Fink-Josephi G., Gutierrez-Vogel S., Hurtado-López L. M., Calderón C.
1 Department of Cardiovascular Surgery Clinic of endovascular procedures at Hospital General de México México and Hospital San Juan de Dios San José, Costa Rica
2 Department of Angiology, Clinic of Endovascular Procedures at Hospital General de México, México and Hospital San Juan de Dios
San José, Costa Rica
3 Department of General Surgery Clinic of Endovascular Procedures at Hospital General de México, México and Hospital San Juan de Dios San José, Costa Rica
4 Department of Cardiology, Clinic of Endovascular Procedures at Hospital General de México, México and Hospital San Juan de Dios
San José, Costa Rica
Aim. The aim of this study was to show the initial experience of a therapeutic alternative in the surgical treatment of thoracic aorta coarctation in adult patients by means of a Talent endoprosthesis implant and angioplasty, maintaining the advantages of minimally invasive surgery, avoiding recurrence, offering safety and protection against dissections, tearing, or even aortic ruptures and, hence, minimizing risks and complications from a thoracic aorta surgery through thoracotomy.
Methods. The authors present a series of 12 cases of thoracic aorta coarctation in adult patients, treated with endovascular surgery by means of a Talent endoprosthesis implant using a transfemoral or iliac access. Age, gender, gradient release, perioperative mortality and morbidity, presence of palpable pulses in the limbs, claudication, and follow-up time.
Results. Eight men and four women, average age of 23.6 years (18 to 38). The average diameter of the normal aorta was 21.65 mm (13.5-24.5 mm) and the smallest diameter at the coarctation site was 3.4 mm (0 to 8 mm). No complications occurred and no patient required blood transfusion. The time spent in the intensive care unit for postoperative monitoring averaged 15 h (12 to 18 h) and hospital stay averaged 2.33 days (1 to 4 days). All patients presented palpable pulses of normal characteristics during the postoperative period. No residual pressure gradient was present requiring treatment. In this series, neither trans nor postoperative complications occurred, and the follow-up time averaged 52 months (6 to 93 months).
Conclusion. Endovascular treatment of thoracic aorta coarctation with protected dilatation is a safe and effective procedure.