Balloon angioplasty of native coarctation of the aorta: Midterm follow-up and prognostic factors

Abstract

Balloon angioplasty of native aortic coarctation is effective in infants and older children. In neonates, balloon angioplasty provides effective palliation only. Aneurysm formation is rare; however, lifetime follow-up is warranted.

Balloon Angioplasty of Native Coarctation and Comparison of Patients Younger and Older Than 3 Months

“…[2][3][4][5][6][7]11,12 In our study, the initial success rate in group A was 76%, which is similar to Western data. There was no difference in anatomy or technique associated with the failure of dilation.…”

Pediatric Therapeutic Cardiac Catheterization

“…The systolic pressure gradient has been reduced to less than 10 mm Hg in about 50% of patients and less than 20 mm Hg in 77% to 91% of patients. 178 Although a complication rate of 17% was reported in the summary data of the Valvuloplasty and Angioplasty of Congenital Anomalies Registry, 173 most complications were related to arterial injury in the smaller patient. These have declined with the use of lowerprofile sheaths and balloons.…”

“…Aneurysms, both acute and late, have been reported in 2% to 6% of these children. 173,178 A number of authors have noted a distinction in success rate between newborns (less than 30 days old) and older patients. Data from the series by Fletcher et al 178 and others 179 suggest that the need for reintervention within a very short period of time is as high as 60% to 70% in infants, whereas no additional intervention was required in 88% of patients older than 7 months.…”

“…173,178 A number of authors have noted a distinction in success rate between newborns (less than 30 days old) and older patients. Data from the series by Fletcher et al 178 and others 179 suggest that the need for reintervention within a very short period of time is as high as 60% to 70% in infants, whereas no additional intervention was required in 88% of patients older than 7 months. Patients with isthmus hypoplasia and other unfavorable anatomic constraints such as long segment narrowing respond less well to balloon angioplasty, whereas discrete membranous or hourglass-type constrictions appear to respond more favorably.…”

Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study

“…Considering disturbed blood flow strongly affects vascular pathogenesis, and vice versa, hemodynamic information is of high clinical importance, amongst others to diagnose cardiovascular malfunctioning and evaluate treatment outcomes. However, the majority of the clinical CoA studies focuses on the prevalence of cardiovascular complications [7,17,37], the rates of mortality [7,17,35] and the postinterventional relief of the pressure drop across the coarctation zone [2,13,18] rather than the correlation of hemodynamic indices with manifestation of late morbidity. As such, the underlying role of hemodynamics in the progression of the disease is currently not well understood.…”