Balloon Angioplasty in Native Coarctation of the Aorta

Efficacy of balloon angioplasty was evaluated in 7 patients with native coarctation of the aorta, diagnosed at our institute. There were 3 boys and 4 girls, the oldest of whom was 8 years old and weighed 21 kg. The remaining patients were all infants with a mean age of 7.25±4.1 months and mean weight of 7.2±1.8 kg. In all patients the procedure was performed through the femoral artery. The monofoil balloon dilation catheter was inflated twice (5 minutes apart), each lasting 5-10 seconds. The aortic pressures and angiopraphic findings obtained before and after dilation were compared. After angioplasty, the mean systolic pressure in the ascending aorta decreased from 152±12 mm Hg to 138±7.7 mmHg (p<0.05), while the systolic pressure in the descending aorta increased from 96±15 mmHg to 118±17 mmHg (p<0.001). With balloon dilation, the mean diameter of the coarctation site increased from 2.8±0.7 mm to 6.8±0.6 mm (p<0.001), and the peak systolic gradient decreased from 56±15 to 20±13 mmHg (p<0.001). The only complication, observed in one patient, was temporary absence of femloral pulse due to arterial injury. During the mean follow-up period of 4.5±2.1 months the peak systolic gradient increased in only one patient with no significant change in the others. The early results of our study show that balloon dilation is effective and safe in patients with native coarctation. We think that these patients should be followed-up closely for late complications, such as recoarctation and aneurysm formation.