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Vol. 60. Issue 6.
Pages 537-543 (1 June 2004)
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Vol. 60. Issue 6.
Pages 537-543 (1 June 2004)
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Tratamiento no quirúrgico de la coartación y recoartación de aorta
Non-surgical treatment of aortic coarctation and recoarctation
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J. Villalba Nogales
Corresponding author
javier.villalba@navegalia.com

Correspondencia: Centro de Salud Collado Villalba Estación (IMSALUD). Los Madroños, 5. 28400 Madrid. España
, L. Fernández-Pineda, J.I. Herráiz Sarachaga, R. Bermúdez-Cañete Fernández, M.aJ. Maitre Azcárate, M. Quero Jiménez (d.e.p.)
Servicio de Cardiología Pediátrica. Hospital Ramón y Cajal. Madrid. España
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Objetivos

Analizar los resultados del intervencionismo no quirúrgico sobre la recoartación y coartación de aorta, valorando los resultados de cada técnica, las complicaciones y su evolución

Pacientes y métodos

Los tratamientos fueron: 51 dilatados con balón por recoartación (86,5%), dos en los que se dilató una coartación nativa (3,3 %) y seis en los que se ha implantado un tubo expansible (stent) por recoartación (10 %). Las edades oscilan entre los 2 y los 236 meses (109 ± 63,45 meses), con un tiempo de seguimiento entre 1 y 156 meses (38,87 ± 32,96 meses)

Resultados

El gradiente predilatación en los niños recoartados fue de 34 ± 11,62mmHg, que descendió a 11 ± 5,38mmHg (p < 0,0001). Doce casos (20,3 %) no obtuvieron una dilatación eficaz. El tamaño de la estenosis fue de 6,7 ± 2,35mm predilatación y aumentó a 9,3 ± 3,10mm (p < 0,0001) con un incremento porcentual del 50,97. Las complicaciones fueron escasas. Seis niños precisaron redilatación posterior. La experiencia con stent muestra un gradiente medio de 32,83 ± 10,62mmHg que descendió a 7,3 ± 3,8mmHg (p < 0,0001) con una relación globo-estenosis de 1,94

Conclusiones

La técnica intervencionista es muy eficaz, tanto en coartación nativa como en recoartación de aorta, en resultados inmediatos y durante la evolución, y con escasas complicaciones. Los stents en niños mayores obtienen igualmente excelentes resultados, abriendo un futuro esperanzador

Palabras clave:
Coartación aórtica
Dilatación con balón
Stent
Objectives

To analyze the results of nonsurgical treatment of aortic coarctation and recoarctation by evaluating the results of each technique, and its complications and outcome

Patients and methods

The results were as follows: 51 children underwent balloon dilatation due to recoarctation (86.5 %); two underwent dilation of a native coarctation (3.3 %) and six underwent stent implantation for recoarctation (10 %). Age ranged from 2 to 236 months (109 ± 63.45 months) with a follow-up of between 1 and 156 months (38.87 ± 32.96 months)

Results

The mean predilatation gradient in children with recoarctation was 34 ± 11.62mmHg, which decreased to 11 ± 5.38mm Hg (p < 0.0001). In 12 patients (20.3 %) effective dilatation was not achieved. The size of the stenosis was 6.7 ± 2.35mm predilatation, which increased to 9.3 ± 3.10mm (p < 0.0001) after dilatation with a percentage increase of 50.97. There were very few complications. Six children required subsequent redilatation. The experience with stent showed a mean gradient of 32.83 ± 10.62mm Hg, which decreased to 7.3 ± 3.8mm Hg (p < 0.0001) with a balloon/stenosis ratio of 1.94

Conclusions

We conclude that the interventionist technique is highly effective in both native coarctation and recoarctation in the short term, as well as subsequently, with very few complications. The stent technique produces equally good results in older children, which is promising for the future

Key words:
Aortic coarctation
Balloon dilatation
Stent
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Copyright © 2004. Asociación Española de Pediatría
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