Balloon Angioplasty for Aortic Coarctation in Adult Patients

Objective- The aim of this study was to evaluate the use of endovascular intervention in managing native and recurrent aortic coarctation in adult patients. Methods- Balloon angioplasty was undertaken transfemorally in 16 patients (mean age 18.3 ± 4 years old) with arterial hypertension in 12 native and 4 recurrent aortic coarctations. Systolic pressure gradient measurements were taken peri-interventionally and in the course of follow-up during conventional angiography and transesophageal echocardiography. The average diameters of the balloon catheters used ranged from 15 to 20 mm. Results- Immediately after aortic angioplasty, the peak systolic pressure gradient decreased from 61 mmHg ± 5.4 to 7.6 mmHg ± 2.2 across the coarctation (P < 0.001). One patient with recoarctation had an unsuccessful immediate result. Restenosis occurred in two patients, who subsequently underwent repeat dilation with successful results. Transesophageal echocardiography was repeated post-procedure and at 6 months postintervention. One patient developed a small aneurysm at the site of dilation. In the course of follow-up, no other major or minor complications were observed. Conclusion- Endovascular intervention appears to be a safe and effective alternative to surgery for the treatment of native and recurrent aortic coarctation in most adult patients with a low rate of complications (Iranian Heart Journal 2004; 5(1,2):51-54).