Intermediate and Long Term Follow Up of Treated Patients with Coarctation of the AortaMohamed Saber Hafez Mohamed
AbstractAbstract We concluded that age at first intervention is the cornerstone of best outcome following CoA repair. The lower age at first intervention causes reduction in BP and complications and gives better LV systolic (measured by GLS) and diastolic functions. The best outcome was present in the Multiple interventions group regarding ABP, GLS and LV diastolic function. ABPM is a good test for masked HTN. We also concluded that Angioplasty is superior to balloon dilation as regards to complications. Furthermore, Covered Stents reduce the risk of Aneurysm formation as compared to Bare Stents. We recommended that the most important predictor for best outcome is early treatment. Early diagnosis is the gateway to prompt treatment. Fetal Echocardiography in suspected cases and Neonatal screening for femoral pulse is mandatory. ABPM is recommended for all patients post CoA repair at least every 5 years to diagnose masked HTN. In order to reduce complications of CoA treatment, it is advised to use Stents rather than balloon dilation whenever possible. The use of smaller balloon/coarctation and balloon/arch ratio (less than 5.6 and 1.0 respectively) carries less incidence of stent fracture and aneurysm formation.
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