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Updated: Aug 9, 2026
Patch Angioplasty in the Rat Aorta or Inferior Vena Cava
Published on: February 27, 2017
Growth of the aorta after prosthetic patch aortoplasty for coarctation in infants
Insights
Patch aortoplasty effectively reduces aortic pressure gradients in infants with coarctation of the aorta. This surgical technique also promotes aortic growth, demonstrating long-term benefits for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Congenital Heart Disease
Background:
- Coarctation of the aorta is a congenital heart defect requiring surgical intervention.
- Patch aortoplasty is a surgical technique for coarctation of the aorta.
- The growth potential of the aorta after patch aortoplasty has not been extensively studied.
Purpose of the Study:
- To evaluate the effectiveness of patch aortoplasty in relieving aortic pressure gradients in infants.
- To assess the longitudinal growth of the aorta after patch aortoplasty repair.
- To compare patch aortoplasty with resection and end-to-end anastomosis for coarctation of the aorta.
Main Methods:
- Retrospective study of 21 infants (<2 years) undergoing prosthetic patch repair for coarctation of the aorta since 1975.
- Analysis of pre- and post-operative systolic blood pressure measurements (right arm and right arm-left leg gradient).
- Review of angiographic findings, including transverse arch diameter and aortic dimensions at the repair site.
Main Results:
- Patch aortoplasty significantly reduced systolic blood pressure and the pressure gradient between the right arm and left leg.
- Aortic dimensions, particularly the relative diameter of the hypoplastic transverse arch, showed increase in a subset of patients postoperatively.
- Long-term follow-up demonstrated aortic growth at the repair site, with one patient showing a larger diameter than adjacent segments after 8 years.
Conclusions:
- Patch aortoplasty is a highly effective method for relieving aortic pressure gradients in infants with coarctation of the aorta.
- The study provides evidence of aortic growth after patch aortoplasty, challenging previous assumptions about the lack of posterior wall growth.
- Patch aortoplasty offers a durable solution for coarctation of the aorta, with favorable long-term anatomical and hemodynamic outcomes.
Abstract:
We have shown that patch aortoplasty relieves the aortic pressure gradient substantially better than resection with end-to-end anastomosis in infants with coarctation of the aorta. Growth of the intact posterior wall of the unresected coarctation after aortoplasty, however, has not yet been demonstrated to occur. We studied 21 infants less than 2 years of age who underwent prosthetic patch repair of coarctation after 1975. Associated lesions were present in 16 patients, and 12 had a concomitant procedure. Two patients died in the hospital, and 4 died later, all of causes unrelated to the coarctation repair. Systolic blood pressure in the right arm declined from 140 +/- 41 mm Hg (mean +/- standard deviation) preoperatively to 101 +/- 19 mm Hg postoperatively in the whole group and to 95 +/- 12 in 10 patients followed for more than 3 years. The right arm-left leg systolic pressure gradient declined from 66 +/- 22 mm Hg to 5 +/- 14 in all patients and to 4 +/- 13 in the group followed more than 3 years. Hypoplastic transverse arch was seen in all but 2 patients. Its relative diameter increased in 6 of 9 patients who underwent catheterization postoperatively and increased more than 50% in 3 patients. Two patients have evidence of narrowing of the aorta at the patch, but both have normal blood pressure in the right arm. In the patient with longest follow-up, an 8-month-old infant seen 8 years after operation, angiograms show the diameter of the aorta at the coarctation to be greater than that at the transverse arch and at the descending aorta.(ABSTRACT TRUNCATED AT 250 WORDS)
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