Initial experience with native coarctation balloon angioplasty

ABSTRACT

Balloon angioplasty was performed in 13 patients with native coarctation of the aorta from November 1988 to October 1989. The patients ranged in age from 4 to 25 years with a mean of 13 years There were 7 females and 6 males. Four patients had associated aortic valvular stenosis; 2 of those had their aortic valves dilated during the procedure. The mean systolic pressure gradient across the coarctation dropped from 67 +/- 29 to 9.6 +/- 12.6 mmHg immediately after angioplasty. The mean diameter of the coarcted segment increased from 6.7 + 2.7 to 13.65 + 2.8 mm. The balloon size was chosen so that its diameter was equal to or 1 - 2 mm less than the diameter of the descending thoracic aorta at the level of the diaphragm, after correction for magnification. The diameter of the balloons used ranged from 12 to 20 mm while the balloon length ranged from 3 to 5.5 cm. One 15 years old male developed a right femoral arterio - venous fistula after the procedure, that was confirmed by subsequent angiography and he was scheduled for surgery. The initial results look promising and follow up of the patients is currently taking place for defining the exact role of angioplasty in dilating native coarctations