Balloon dilation of native aortic coarctation in infancy
M O Galal1, A A Schmaltz, M Joufan
1King Faisal Specialist Hospital and Research Center, MBC J 16, 40047, 21499 Jeddah, Saudi Arabia. ogalal@yahoo.com
Zeitschrift Fur Kardiologie
|September 26, 2003
Summary
Balloon dilation effectively reduces aortic coarctation pressure gradients in infants. However, higher reintervention rates in younger infants suggest it
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Aortic coarctation is a critical congenital heart defect.
- Balloon dilation is a treatment option, but its efficacy in infants is debated.
Purpose of the Study:
- To evaluate the safety and efficacy of balloon dilation for native aortic coarctation in infants.
- To assess long-term outcomes and identify factors influencing success.
Main Methods:
- Retrospective analysis of 80 infants (<12 months) undergoing balloon dilation for aortic coarctation (1985-1999).
- Assessment of acute procedural success, complications, and long-term reintervention rates.
- Subgroup analysis based on age at intervention.
Main Results:
- Initial success (gradient <20 mmHg) in 68.8% of patients.
- Acute complications included intimal tears (12.5%) and femoral artery obstruction (21.3%).
- Long-term, 33% required redilation, and 45% remained free from reintervention.
- Infants ≤3 months had significantly higher residual stenosis rates.
Conclusions:
- Balloon dilation is acutely effective but associated with significant reintervention rates, especially in younger infants.
- It may be considered palliative for very young infants with severe left ventricular dysfunction or prohibitive surgical risks.
- Careful patient selection and consideration of age are crucial for optimal outcomes.
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