RESUMEN
Twenty patients aged 5ms. to 33 years with unoperated aortic coarctation [CoA], underwent percutaneous balloon dilatation between March 1987 and April 1990. Pre- and post-dilatation pressures, proximal and distal to the coarctation as well as aortography in the AP and LAO views were obtained. One balloon was used in 14 patients whereas 2 balloons were used in two. The balloon diameter used was 20% less than the aortic diameter just above the diaphgram. Balloon length varied between 40-80 mms. Before dilatation the peak systolic gradient [PSO] ranged from 45-l60 mmHg., with a mean of 75 mmHg. The mean systolic gradient ranged from 20-70 with a mean of 38mmHg. Post-dilatation PSO dropped to 0-60 with a mean of 3mmHg. Aortography revealed a substantial increase in the diameter at the site of CoA in all patients and decrease of collaterals. Clinical and radiologic follow-up showed no evidence of restenosis or aneurysm formation. Pressure measurement and aortography done 6-12 months after dilatation in 4 patients, showed no restenosis or aneurysm formation. No intraprocedural complications were encountered. However the first patient developed infective endarteritis and dissection at the site of CoA which mandated surgical interference. Femoral artery obstruction occured in two patients; temporary in one and necessitating thrombendarterectomy in the other. Early and intermediate results suggest that balloon dilatation offers an effective and safe non-surgical alternative for the treatment of discrete CoA in children and adults. However long term follow .up will ultimately determine the efficacy and safety of this procedure