Short- and midterm results of balloon angioplasty for the treatment of coarctation of the aorta in neonates

Background: In this study, we reviewed our clinical experience along with the existing data and short- and midterm results of balloon angioplasty for coarctation of aorta in neonates. Methods: The data of 51 neonates 41 boys and 10 girls; mean age 13 9 clays; range 1 to 30 days) who underwent balloon angioplasty for aortic coarctation between December 2004 and March 2010 were retrospectively analyzed. Results: Isolated coarctation was found in 13 patients (25%) and complex coarctation in 38 (75%). The left ventricular dysfunction was seen in 18 patients (35.3%), while 17 patients (33.3%) had isthmus hypoplasia. The most common concomitant abnormality was ventricular septal defect (VSD) (49%). Twenty-nine patients (56.9%) had pulmonary hypertension. The mean systolic pressure gradient across the coarctation site fell from 36 +/- 20 mmHg before dilatation to 8.6 +/- 7.0 mmHg following the intervention. One patient developed femoral artery thrombosis. The mean follow-up was 8.7 +/- 9.6 months (range 1-46, median 6 months). Recoarctation developed in 20 patients (39.2%) after an average 3.2 +/- 3.1 months. Of these, nine (45%) with recoarctation underwent repeated angioplasty and 11 (55%) surgical repair. During follow-up of 1-7 months, seven (13.7%) patients died. Conclusion: Our short- and midterm results suggest that balloon angioplasty has a higher recoarctation rate than surgery. Therefore, balloon angioplasty should be done to ensure survival until full corrective surgery is performed in patients with complex cardiac disease and poor overall condition.