CoA Stenting in Young Population: Height Matters

Background: Stenting of an aortic coarctation (CoA) is an established method for the treatment of native or recurrent CoA in adults. However, CoA stenting in the pediatric population poses a challenge of repetitive re-dilations due to the somatic growth. Once a stent is placed in a young child, it is still an unanswered question at which age and how often a re-dilation is necessary.

Methods: In the first part of this retrospective study, all stent implantations and stent re-dilations for 155 patients with CoA from German Heart Centre Berlin, who are younger than 20 years of age were evaluated. The median age at intervention was 10.1 years (range 0.5–19 years). To find an association between the stent diameter and different body parameters correlation analysis was performed on the data. Regardless of the spread for the whole population, a significant linear correlation between stent diameter and body length was found. Subsequently, a formula f(x) = 0.0856 · x + 1.637, where x represents body height, to calculate the stent diameter is derived. This formula yields a minimum and maximum reference body length for each stent diameter, which is reached at a different age for children with a different speed of growth. In the second part of the study, this formula was validated using a different study population from the German Heart Centre Munich. This included 330 interventions in 198 patients under the age of 20 with CoA or re-CoA, undergoing endovascular stent implantation at a median age of 8.1 years (range 0.1–19 years). This confirmed a linear relationship between body height and stent diameter, as well as the minimum and maximum reference body length for each stent diameter.

Conclusion: With a linear relation between body length and the stent diameter, it is possible to estimate the size of the needed stent and the number of further required cardiac catheterizations. The results are developed into gender-specific tables, allowing the pediatric cardiologist to quickly estimate the timing and the total number of future interventions until the patient is fully grown.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
11 February 2025