Balloon Angioplasty for Native Coarctation of the Aorta: Acute and Mid-Term Results

BACKGROUND: Balloon angioplasty is an accepted treatment for recurrent coarctation of the aorta. Application of this technique to patients with native coarctation is controversial. OBJECTIVE: To report on the immediate and mid-term results of this procedure in patients with native coarctation, including infants <6 months of age. METHODS AND RESULTS: Twenty-four children underwent balloon angioplasty of their coarctation at a median age of 2 yr. (range 2 weeksD14.7 yr.) and median weight of 13 kg (range 3D64 kg). The mean peak systolic gradient across the coarctation decreased from 40 +/- 14 to 9 +/- 6 mmHg (p < 0.001) and the mean diameter of the narrowest area improved from 4.1 +/- 2.1 to 7.5 +/- 2.5 mm (p < 0.001). Four patients had recurrence of their coarctation, 3 of whom were < 3 months of age. Two of these patients had successful repeat dilation. At a mean follow-up interval of 2.4 +/- 1.7 years, one patient (4%) developed an aneurysm. Three patients underwent surgical repair (two for recurrence and one for resection of the aneurysm). The remaining patients (87.5%) are normotensive with mean peak systolic gradient between the right arm and the lower extremity of 4 +/- 9 mmHg. CONCLUSION: Balloon angioplasty for native coarctation is an effective and safe method for most patients with coarctation. Repeat dilation is possible and surgical repair of an aneurysm is safe.