Balloon Angioplasty for Coarctation of Aorta: Initial Experience

Balloon angioplasty has been used to treat patients with coarctation of aorta as an effective and alternative method to surgical correction. We presented results of 12 balloon coarctation angioplasty in 11 patients. They ranged in age 13 days to 13 years (median 7 months). Eight patients had associated cardiac defects. Eight procedure in native coarctation, four in recoarctation were done. Balloon angioplasty produced a reduction in the peak to peak coarctation gradient from 38.4±22.6 (0-70) to 10.6±9.8 mmHg (p<0.001). The systolic peak to peak gradient decreased to 33 mmHg in only one patient with isthmic hypoplasia, the other's gradients were less than 20 mmHg. Mean aortic diameter in coarctation region increased 4.2±3.3 (1.7- 13.8) to 8.8±4.8 (3.3-1 8.4) mm. The gradient decreased 36.6±7 .6 to 21 ± 11.5 mmHg in four patients whose increase of aortic diameter in coarctation region was less than two times, but it decreased 43.9±23.2 to 8.1 ±6.5 mmHg in others. There was no difference in ratio of balloon diameter/diaphragmatic aorta, but diaphragmatic aorta/coarctation (2.5±0. 73 vs 1.76±0.6), balloon/coarctation ratio ( 1.0±0.17 vs 0.97±0.24) and isthmus/diaphragmatic aorta (0,82±0,13 vs 0,71±0,02) were statistically different. There was not early aneurysm in patients and any immediate surgery did not required. Femoral artery complication occurred in 4 patients (33%) who were Jess than 6 months. We observed a case of paradoxical hypertension after balloon angioplasty. Recoarctation developed in one of 11 patients in mean 7±16.2 months follow-up and was succesfully treated by repeat balloon angioplasty. In conclusion; balloon coarctation angioplasty for coarctation of aorta provides safe and effective alternative to surgical repair in newborn and patients with high surgical risks and decreased coarctation gradient.