Related Experiment Videos
Transluminal balloon coarctation angioplasty: experience with 27 patients
Insights
Transluminal balloon angioplasty (BA) safely treats coarctation of the aorta (COA). This effective procedure significantly reduces pressure gradients and increases aortic diameter in patients of all ages.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Coarctation of the aorta (COA) is a congenital heart defect requiring intervention.
- Surgical repair may lead to restenosis, necessitating alternative treatments.
- Infants with preductal COA often present with critical illness.
Purpose of the Study:
- To evaluate the safety and efficacy of transluminal balloon angioplasty (BA) for coarctation of the aorta (COA).
- To assess the impact of BA on pressure gradients and aortic diameter in diverse patient groups.
Main Methods:
- Transluminal balloon angioplasty (BA) was performed in 27 patients with COA (infants, post-surgical restenosis, unoperated).
- Sequential balloon inflations to 100-120 psi were used across the coarctation site.
- Pressure gradients and aortic dimensions were measured before, immediately after, and during follow-up (3-24 months).
Main Results:
- BA was performed without complications in all patients.
- Immediately post-BA, mean systolic pressure gradient decreased significantly (49 to 10 mm Hg, p<0.01).
- Mean COA diameter increased significantly (3.9 to 9.6 mm, p<0.01), with sustained results at follow-up.
Conclusions:
- Transluminal balloon angioplasty is a safe and effective treatment for coarctation of the aorta.
- BA provides significant hemodynamic and anatomic improvement in COA patients.
- It serves as a valuable palliative option for critically ill infants with COA.
Abstract:
Transluminal balloon angioplasty (BA) was performed in 27 consecutive patients with coarctation of the aorta (COA), including 7 infants with preductal COA, 7 patients with restenosed COA after surgical repair, and 13 older children and 1 adult with unoperated COA. The patients were 4 days to 27 years old. The balloon was positioned across the COA and inflated sequentially to pressures of 100 and 120 psi, each inflation lasting for 5 to 10 seconds. Peak systolic pressure gradient (PSG) across the COA was recorded and an aortogram was performed before and immediately after BA. PSG also was recorded during follow-up studies performed in 13 patients 3 to 24 months after BA. BA was performed without complications in each patient. Immediately after BA, the mean PSG was reduced from 49 +/- 21 to 10 +/- 7 mm Hg (p less than 0.01), and the mean COA diameter increased from 3.9 +/- 1.4 to 9.6 +/- 3.6 mm (p less than 0.01). After a follow-up period of 3 to 24 months, the mean PSG remained low (15 +/- 11 mm Hg) and the mean COA diameter increased to 10.5 +/- 4.6 mm. BA can be performed safely. It can be a useful palliative treatment in seriously ill infants with COA.