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Bailout Stenting Safe and Effective in Newborns

Newborns with aortic coarctation can later have defect repaired

FRIDAY, March 26 (HealthDay News) -- In newborns with aortic coarctation, a congenital narrowing of the aorta, bailout stenting and later stent removal and corrective surgery can be safe and effective, according to a study in the March 1 issue of Catheterization and Cardiovascular Interventions.

Matthias Gorenflo, M.D., and colleagues from University Clinic Leuven in Belgium reviewed the medical records of 15 neonates with aortic coarctation at their institution who underwent stenting with bare stents so that corrective surgery could be deferred until the infants had stabilized and gained weight.

The researchers found that all 15 patients had adequate aortic flow and 13 patients had preservation of the femoral artery. Twelve patients had their stents removed, occurring after 2.8 months in patients with simple stented coarctation and after 3.0 months in patients with complex cardiac malformation. Two patients died before stent removal (deaths were unrelated to stenting), and one patient is awaiting stent removal. The final maximum systolic velocity was 1.7 m/sec across the aortic arch.

"In infants with critical coarctation, bailout stenting and later surgical stent removal and arch repair can be performed safely and effectively with low morbidity," Gorenflo and colleagues conclude. "This strategy when applied in selected patients, such as in the very premature, critical, or complex neonate, compares competitive with current treatment strategies on overall mortality and morbidity."

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