BACKGROUND: Midaortic syndrome is often associated with refractory hypertension. The aim of our study was to better understand the short- and medium-term outcomes in this patient population utilizing a multidisciplinary management approach. METHODS: We conducted a review of patients with midaortic syndrome treated at our institution over the past 30 years. RESULTS: Fifty-three patients presented at a median age of 6.7 years (birth to 28.7 years). Thirty-five patients (66 %) underwent invasive management (percutaneous techniques: 21; surgical techniques: 5; both: 9). Percutaneous interventions were acutely successful in decreasing the gradient across the obstruction and degree of luminal stenosis. However, freedom from reintervention was 58 % at 1 year and 33 % at 5 years. Freedom from reintervention after a surgical procedure was longer: 83 % at 1 year and 72 % at 10 years. At the most recent follow-up, the majority of patients (69 %) were normotensive. The median duration between time of presentation and achievement of blood pressure control was 5.7 (0.4-21.1) years. The median number of anti-hypertensive medications was 1 (0-5). CONCLUSIONS: A multidisciplinary management strategy which couples comprehensive medical management with catheter-based and surgical interventions can lead to adequate blood pressure control and preservation of end-organ function in patients with midaortic syndrome.
BACKGROUND:Midaortic syndrome is often associated with refractory hypertension. The aim of our study was to better understand the short- and medium-term outcomes in this patient population utilizing a multidisciplinary management approach. METHODS: We conducted a review of patients with midaortic syndrome treated at our institution over the past 30 years. RESULTS: Fifty-three patients presented at a median age of 6.7 years (birth to 28.7 years). Thirty-five patients (66 %) underwent invasive management (percutaneous techniques: 21; surgical techniques: 5; both: 9). Percutaneous interventions were acutely successful in decreasing the gradient across the obstruction and degree of luminal stenosis. However, freedom from reintervention was 58 % at 1 year and 33 % at 5 years. Freedom from reintervention after a surgical procedure was longer: 83 % at 1 year and 72 % at 10 years. At the most recent follow-up, the majority of patients (69 %) were normotensive. The median duration between time of presentation and achievement of blood pressure control was 5.7 (0.4-21.1) years. The median number of anti-hypertensive medications was 1 (0-5). CONCLUSIONS: A multidisciplinary management strategy which couples comprehensive medical management with catheter-based and surgical interventions can lead to adequate blood pressure control and preservation of end-organ function in patients with midaortic syndrome.
Authors: J C Stanley; L M Graham; W M Whitehouse; G B Zelenock; E E Erlandson; J L Cronenwett; S M Lindenauer Journal: Am J Surg Date: 1981-08 Impact factor: 2.565
Authors: S A Rao; K R Mandalam; V R Rao; A K Gupta; S Joseph; M N Unni; R Subramanyan; K S Neelakandhan Journal: Radiology Date: 1993-10 Impact factor: 11.105
Authors: M P Fava; G B Foradori; C B García; F O Cruz; J G Aguilar; A S Kramer; F E Valdés Journal: J Vasc Interv Radiol Date: 1993 Sep-Oct Impact factor: 3.464
Authors: Jillian K Warejko; Markus Schueler; Asaf Vivante; Weizhen Tan; Ankana Daga; Jennifer A Lawson; Daniela A Braun; Shirlee Shril; Kassaundra Amann; Michael J G Somers; Nancy M Rodig; Michelle A Baum; Ghaleb Daouk; Avram Z Traum; Heung Bae Kim; Khashayar Vakili; Diego Porras; James Lock; Michael J Rivkin; Gulraiz Chaudry; Leslie B Smoot; Michael N Singh; Edward R Smith; Shrikant M Mane; Richard P Lifton; Deborah R Stein; Michael A Ferguson; Friedhelm Hildebrandt Journal: Hypertension Date: 2018-02-26 Impact factor: 10.190