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 & Results. Twenty;four children underwent balloon angioplasty of their coarctation at a median age of 2 yr. (range 2 weeks-14.7 yr.) and median weight of 13 kg (range 3-64 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.