S C Brown1, A D Bruwer. 1. Paediatric Cardiology, Department of Paediatrics and Child Health-G69, University of the Free State, Bloemfontein, South Africa.
Abstract
OBJECTIVE: Balloon angioplasty of native coarctation of the aorta is gaining acceptance as an alternative to surgery in children. The aim of this study was to assess the acute and midterm effectiveness and safety of the procedure. METHODS: During a 3-year period, nine patients with native coarctation underwent balloon angioplasty at a median age of 2.9 years (range: 4 mo - 12 y) and median weight of 11 kg (range: 3.1 - 51 kg). Balloon diameter selected was at least twice the diameter of the narrowed segment, but never more than the diameter of the aorta at diaphragmatic level. RESULTS: There was a significant improvement in the mean systolic gradient across the coarctation from 36 +/- 13mm Hg to 4 +/- 4 mm Hg (p < 0.001), and in the mean diameter of the narrowed segment from 4 +/- 1.3 mm to 7.2 +/- 2.7 mm (p < 0.001). There was no immediate mortality or complication. Follow-up catheterisation was done in eight patients, a mean of 2.7 years (range: 0.8 - 4 y) after the initial procedure. No evidence of restenosis was found, but one patient developed an aneurysm that was surgically resected. CONCLUSION: Balloon angioplasty is effective and safe for the treatment of native coarctation in children. Radiographic follow-up is advisable in the midterm. Balloon angioplasty offers an alternative to surgery in the treatment of selected children older than 3 months with native coarctation of the aorta.
OBJECTIVE: Balloon angioplasty of native coarctation of the aorta is gaining acceptance as an alternative to surgery in children. The aim of this study was to assess the acute and midterm effectiveness and safety of the procedure. METHODS: During a 3-year period, nine patients with native coarctation underwent balloon angioplasty at a median age of 2.9 years (range: 4 mo - 12 y) and median weight of 11 kg (range: 3.1 - 51 kg). Balloon diameter selected was at least twice the diameter of the narrowed segment, but never more than the diameter of the aorta at diaphragmatic level. RESULTS: There was a significant improvement in the mean systolic gradient across the coarctation from 36 +/- 13mm Hg to 4 +/- 4 mm Hg (p < 0.001), and in the mean diameter of the narrowed segment from 4 +/- 1.3 mm to 7.2 +/- 2.7 mm (p < 0.001). There was no immediate mortality or complication. Follow-up catheterisation was done in eight patients, a mean of 2.7 years (range: 0.8 - 4 y) after the initial procedure. No evidence of restenosis was found, but one patient developed an aneurysm that was surgically resected. CONCLUSION: Balloon angioplasty is effective and safe for the treatment of native coarctation in children. Radiographic follow-up is advisable in the midterm. Balloon angioplasty offers an alternative to surgery in the treatment of selected children older than 3 months with native coarctation of the aorta.