Improvement of Left Ventricular Mass Following Balloon Angioplasty of Native Coarctation of the Aorta: Midterm follow-up in Cairo University, Children’s Hospital.

ABSTRACT

Objectives: We evaluated mid-term results of balloon angioplasty (BAP) of native coarctation of the aorta (CoA) in children. There is paucity of data on left ventricular hypertrophy (LVH) and left ventricular mass (LVM) post balloon dilatation of native CoA, hence we also assessed LVM regression. Study Design: Thirteen children were included (11 boys, 2 girls) with median age at intervention of 16 months (4-96 months) and all underwent BAP for native CoA. Patients were followed-up by transthoracic echocardiography assessment of left ventricular function, LVM, recoarctation, and other complications. Follow-up period ranged from 9– 36 months (mean±SD, 24.38±8.22 months). Results: The mean peak systolic gradient decreased to ≤20 mmHg in 11 patients (84.6%), mean peak systolic gradient decreased from 61.15±12.44 mmHg before to 18.85±13.72 mmHg and 15.38±6.27 mmHg immediately after angioplasty and at last follow-up, respectively (P=0.00). There was recurrence of mean pressure gradient in two patients; the first patient was 4 months old and had a successful balloon angioplasty six months later and surgery was performed in the second patient. Ventricular function improved in all patients, mean left ventricular mass index (LVMI) during diastole significantly decreased from 142.27±131.22 before angioplasty to 69.55±54.38 g/cm2 at last follow-up (P=0.038). None of the patients developed aneurysms or any other complications at last follow-up. Conclusion: Considering its mid-term outcome, BAP is a successful and reliable procedure in the treatment of CoA. Follow-up by LVMI can be a noninvasive tool to assess mid and long term improvement.