CSI Focus Workshop

coarctation

FRIday, june 24, 2022

The treatment of coarctation in small children and infants in the catheter laboratory has developed rapidly in recent years. Stent technology and improved techniques have pushed down the weight at which primary interventional treatment is considered superior to a conventional surgical approach. Our aim in the first session of the coarctation workshop is to update and engage in debate on the key issues such as when to balloon and when to stent, the role of advanced imaging and the development of new stent technology. Most importantly we want to open the debate and discussion involving surgeons and interventional cardiologists regarding collaborative decision making in small children with coarctation.

In the second session we deal with issues related to successful patient management with coarctation; identification and monitoring of cerebral aneurysms; how to stabilize stents during deployment; how to maximize the benefits of fusion imaging? We anticipate lively and open debates as we hear from neuroradiologists, cardiac imaging specialists as well as interventional KOLs.

The morphology, complexity and tissue characteristics of coarctation of the aorta changes profoundly as we move through the chronological stages of life meaning the approach to coarctation in older adults needs to be specific. In the final session of this workshop we will discuss tips and tricks for dealing with the interrupted or nearly interrupted coarctation and the risk benefit of complex aortic interventions in relatively well adults. We will also look at the current portfolio of covered stents which are so useful in this age range.

 

PRELIMINARY PROGRAM - COARCTATION FOCUS WORKSHOP

DEVELOPED BY: GARETH MORGAN & GREGOR KRINGS

Intervention from very low birth weight to 20kg - unwelcome guests?
Morphology and anatomy in neonates and infants
When do we need more than an ECHO? Pre-procedural MRI vs CT in infants and small children
When to place a stent? When to balloon? 

Recorded case: complex post-op coarctation

Re-coarctation / arch stenosis after single ventricle arch reconstruction

Debate:

  • Few lesions will still require an open procedure 10 years from now
  • Most lesions will still require an open procedure 10 years from now
“A stent for life”- dream or reality?
Conundrums
Live case transmission from Our Lady's Children's Hospital, Dublin, Ireland

Assessment and implications of cerebral aneurysms in coarctation patients - My approach 

Follow-up and management of aortic aneurysms in coarctation patients - My approach

Borderline coarctation – How do I provoke a hemodynamic indication in the cath lab?

Borderline coarctation - Strategies to prevent stent dislodgement

Head and neck vessels – When and how to protect?
Fusion imaging and 3DRA - What you need to know?
Intervention in older adults - From bread and butter to the best worst approach?

Referral, MDT discussion and comorbid considerations for the “elderly” (over 40)

Near atresia (case based)

Real atresia (case based)

Surgical standby - planning for irredeemable disaster?

Panel discussion: when to do nothing in adult coarctation cases

Prepare for the unexpected! (case based)

Self-expanding stent grafts in coarctation patients – what do we need to know?
Transverse arch stenting in persistent hypertension- worth the stretch?

Portfolio of covered stents:

  • Bentley
  • Optimus 
  • CP
  • G-Armor
  • AndraStent

BROWSE THE FULL CSI 2022 PROGRAM

This workshop is part of CSI Frankfurt 2022, the leading conference on catheter interventions in congenital, structural and valvar heart disease and heart failure, which will take place June 22-25, 2022 in Frankfurt, Germany. Drop in for the day, or join us for the full 4-day program providing a comprehensive overview of the field presented by experts and key opinion leaders from all over the world.