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  1. Sadiq MA, Azman W, Abidin IZ
    J Invasive Cardiol, 2012 Jan;24(1):E13-5.
    PMID: 22210591
    Permanent complete heart block (CHB) secondary to the loss of first septal perforator after percutaneous coronary intervention (PCI) of the left descending artery (LAD) is an extremely rare complication. We describe a case report where a patient underwent PCI of proximal LAD, complicated by loss of first septal perforator, septal infarction, and bifasicular block, which progressed to symptomatic delayed CHB. One week later, the patient required implantation of a permanent pacemaker following failure to wean off the transvenous temporary pacing maker.
  2. Pei L, Abrahamyan L, Sklar JC, Muthuppalaniappan A, Romero RG, Benson L, et al.
    J Invasive Cardiol, 2023 Sep;35(9).
    PMID: 37983109 DOI: 10.25270/jic/23.00124
    OBJECTIVE: Outcomes after adult coarctation of the aorta (CoA) stenting is scant. We explored predictors of aortic remodeling after stent implantation and report early- and intermediate-term clinical outcomes.

    METHODS: Adult patients who underwent stenting between July 2003 and December 2017 were included in this single-center retrospective study. We created a novel index of aortic volumetric and diameter changes using computed tomography (CT)/magnetic resonance (MR) images measured through TeraRecon and AngioQ. Predictors of aortic remodeling were explored using univariable linear regression analysis.

    RESULTS: One hundred and thirty-four patients (mean age 35.2 years, 58.2% men) underwent CoA stenting. Paired aortic diameter measurements were available in 20 patients, and 40 paired patients in volumetric measurements. There was significant reduction in aortic diameter immediately proximal to the left carotid and subclavian arteries, and the aorta distal to the stenosis (P less than .05) at follow-up. There was a significant volumetric reduction in the ascending aorta, aortic arch, and the aortic segment most proximal to the top of the stent (P less than .05). Univariate predictors of aortic remodeling included sex, age, presence of previous surgical repair, aortic valve morphology, and the number of antihypertensive medications. Mean follow-up time was 4.0 ± 3.8 years, where 5% of patients underwent reintervention due to complications, 3% developed aneurysms, and 3% had stent fractures.

    CONCLUSIONS: This study is the first to examine the anatomical changes that occur in the aorta post stent repair through analysis of serial imaging. Patients with stent-repaired coarctation demonstrated negative remodeling in multiple areas of the aorta with regards to the aortic diameter and volumetric measurements.

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