Relief of coarctation of the aorta without thoracotomy: the experience with percutaneous balloon angioplasty

ABSTRACT

The purpose of this paper is to present our experience with percutaneous balloon angioplasty [PBA] for coarctation of the aorta [COA]. The children between the ages of one month and 11 years [mean age 18 months] underwent PBA during an eight-month period ending September 1985. Numbers 5 to 9 French catheters with 5-to 15-mm balloons were used, depending upon the size of the angiographically measured coarcted segment and the aorta proximal to COA. The peak inflation pressure used in the balloons varied from 4 to 8 atmospheres of pressure and the duration of inflation was 8 to 15 seconds. At least four balloon dilatations were performed in every case. Following PBA for COA, descending aortic pressure rose from 86.4 +/- 17.7 to 107.8 +/- 20 [p< 0.02] and the peak systolic pressure gradient across the COA fell from 44.1 +/- 19.1 to 8.5 +/- [p< 0.001]. Increase in the angiographically measured coarcted segment, decrease in Doppler estimate of coarctation gradient, and improvement in the femoral pulses also occurred. No significant complications were encountered. PBA for COA is a safe and effective alternative to surgical coarcttectomy. It may become the procedure of choice for treatment of coarctation of the aorta favorable long-term results are documented