Comparison Between Surgical vs Balloon Angioplasty vs Intravascular Stent Placement for Recurrent or Native Coarctation of the Aorta
This study is a prospective, nonrandomized, observational, multi-center (north america and Western europe) study in which a comparison between surgery, balloon angioplasty and intravascular stent placement for native and recurrent coarctation is made. The hypothesis is that intravascular stent placement will be superior in the immediate and intermediate follow-up.
Patients who meet criteria will be enrolled if they meet the inclusion criteria of weight [Greater Than]10 kg, presence of coarctation with a gradient [Greater Than] 20 mmHg requiring therapy. The therapy will be at the discretion/preference of the cardiologist at the patient's local institution; it will not be randomized.
Success will be defined as a residual gradient [Less Than] 20 mmHg following intervention. Failure will be defined as a residual gradient [Greater Than] 20 mmHg, occurrence of a serious complication, or death. Complications will be documented immediately and at scheduled follow-up.
endpoints for each patient will be death or the patient reaching 60 months out from the initial procedure. Data reporting will be handled at the principal institution, Wayne State university in Detroit.
The study information collected, both during the procedure and during follow-up visits, is already collected per routine standard patient care. There are no extra study visits. The duration of the regular visit will not be lengthened because of the study.
Patients >= 10 kg body weight
Presence of a significant coarctation as determined by an upper to lower extremity blood pressure gradient > 20 mmHg, decreased LV function (SF < 25%) or aortic insufficiency with an upper to lower extremity blood pressure gradient > 10 mmHg
Standard treatment would include surgical or transcatheter treatment of the coarctation segment
Patients with known or suspected arteritis will be analyzed separately
Patients who do not require other surgical procedures that would entail correction for the coarctation segment in the same setting