0280: Percutaneous balloon angioplasty of aortic recoarctation before one year of age

Objective The main objective was to evaluate the safety and the efficacy of balloon angioplasty of post-surgical aortic recoarctation before one year of age. The secondary objective was to identify factors potentially associated with a failure of the procedure. Method Data from children who have one or more balloon angioplasty for aortic recoarctation before one year of age were retrospectively collected from 2006 to 2014. Results 14 children (17 procedures) have been included. The procedure immediately failed in 2 patients who underwent a new surgery. All the other 12 patients still remained free of recoarctation after one procedure for 10 of them, 2 procedures for another one and 3 procedures for the last one. Three complications due to the procedure occurred: one iliac artery thrombosis, one coronary embolism and one transitory stroke. These complications totally recovered before discharge. No aortic dissection or aneurysm has been reported. Comparing the 5 procedures which need a further intervention with the others, we observed that a higher peak gradient measured during the catheterization before (45mmHg (range 36-60) vs 32mmHg (range 10-47)) and after the angioplasty (36mmHg (range 30-50) vs 25mmHg (range 5-50)), and a lower ratio balloon size/transverse arch diameter (1.07 (range 0.88-1.20) vs 1.28 (range 0.94-1.82)) were associated with a failure of the procedure. Conclusion Balloon angioplasty of aortic recoarctation before one year of age is efficient. A lower ratio balloon size/transverse arch diameter was associated with a higher failure of the procedure that suggests the use of bigger balloon.