Rasha I Ammar1. 1. Department of Pediatrics, Faculty of Medicine Cairo University, Pediatrics, Cairo, Egypt. rashaammar@gmail.com
Abstract
BACKGROUND: Despite more than 20 years of experience, balloon angioplasty as treatment for native coarctation of the aorta (CoA) during childhood remains controversial. METHODS AND RESULTS: Fifty-three pediatric patients with discrete native coarctation for whom balloon angioplasty (BA) was performed were included in this study. Patients were divided into 3 groups: group A patients, ≤3 months of age (n = 20); group B patients, between 4-12 months of age (n = 15); and group C patients, between 1 and 12 years (n = 18). Mean age at BA was 0.9 months for group A, 6.5 months for group B, and 7.8 years for group C. The mean body weight was 4.2 kg for group A, 8.6 kg for group B, and 15.3 kg for group C. Successful BA was achieved in 48 of 53 patients (90.6%). Follow-up revealed re-coarctation in 13/53 patients (24.5%); 6 patients with restenosis were referred for surgery, and 7 underwent a second BA procedure. At the end of the study period, BA was effective in 88.7% of patients. The incidence of peripheral vascular complications following BA was higher in group A (17%). Aneurysms were detected in 3/20 (15%) in group A and 2/15 (13.3%) in group B. CONCLUSIONS: BA is a safe and effective treatment for native aortic coarctation. Due to the risk of aneurysm formation in children, cautious selection of patients, the use of low-profile balloons, and state-of-the-art postoperative care are imperative to improve patient outcomes and decrease the risk of complications.
BACKGROUND: Despite more than 20 years of experience, balloon angioplasty as treatment for native coarctation of the aorta (CoA) during childhood remains controversial. METHODS AND RESULTS: Fifty-three pediatric patients with discrete native coarctation for whom balloon angioplasty (BA) was performed were included in this study. Patients were divided into 3 groups: group A patients, ≤3 months of age (n = 20); group B patients, between 4-12 months of age (n = 15); and group C patients, between 1 and 12 years (n = 18). Mean age at BA was 0.9 months for group A, 6.5 months for group B, and 7.8 years for group C. The mean body weight was 4.2 kg for group A, 8.6 kg for group B, and 15.3 kg for group C. Successful BA was achieved in 48 of 53 patients (90.6%). Follow-up revealed re-coarctation in 13/53 patients (24.5%); 6 patients with restenosis were referred for surgery, and 7 underwent a second BA procedure. At the end of the study period, BA was effective in 88.7% of patients. The incidence of peripheral vascular complications following BA was higher in group A (17%). Aneurysms were detected in 3/20 (15%) in group A and 2/15 (13.3%) in group B. CONCLUSIONS: BA is a safe and effective treatment for native aortic coarctation. Due to the risk of aneurysm formation in children, cautious selection of patients, the use of low-profile balloons, and state-of-the-art postoperative care are imperative to improve patient outcomes and decrease the risk of complications.
Authors: Joshua D Kurtz; Agustin E Rubio; Troy A Johnston; Brian H Morray; Thomas K Jones Journal: Pediatr Cardiol Date: 2022-03-10 Impact factor: 1.838