Balloon Angioplasty for Aortic Coarctation

ObjectiveThe aim of this study was to evaluate the use of endovascular intervention in managing native and recurrent aortic coarctation in adult patients. MethodsBalloon angioplasty was undertaken transfemorally in 16 patients (mean age 18.3 ± 4 years old) with arterial hypertension in 12 native and 4 recurrent aortic coarctations. Systolic pressure gradient measurements were taken peri-interventionally and in the course of follow-up during conventional angiography and transesophageal echocardiography. The average diameters of the balloon catheters used ranged from 15 to 20 mm. ResultsImmediately after aortic angioplasty, the peak systolic pressure gradient decreased from 61 mmHg ± 5.4 to 7.6 mmHg ± 2.2 across the coarctation (P < 0.001). One patient with recoarctation had an unsuccessful immediate result. Restenosis occurred in two patients, who subsequently underwent repeat dilation with successful results. Transesophageal echocardiography was repeated post-procedure and at 6 months postintervention. One patient developed a small aneurysm at the site of dilation. In the course of follow-up, no other major or minor complications were observed. ConclusionEndovascular intervention appears to be a safe and effective alternative to surgery for the treatment of native and recurrent aortic coarctation in most adult patients with a low rate of complications (Iranian Heart Journal 2004; 5(1,2):51-54).