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The role of balloon dilation of native aortic coarctation in neonates, infants and children

Published online by Cambridge University Press:  19 August 2008

Omar Galal ,
Zohair Al Halees ,
Shakeel Qureshi ,
Begonia Gometza ,
Mohammed Eid Fawzy ,
Fadel Al Fadley ,
Bruce Dunn  and
Carlos Duran
Omar Galal*
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Zohair Al Halees
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Shakeel Qureshi
Affiliation:
Department of Pediatric Cardiology, Guy's Hospital, London
Begonia Gometza
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Mohammed Eid Fawzy
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Fadel Al Fadley
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Bruce Dunn
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
Carlos Duran
Affiliation:
From the Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh
*
Dr. Omar Galal, Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, MBC 16, PO Box 3354, Riyadh 11211, Saudi Arabia. Tel. 966 1 442 7470; Fax. 966 1 442 7482.
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Abstract

In 38 children with aortic coarctation between the age of three weeks and 16 years, 44 balloon dilation procedures were attempted. At initial catheterization (n=38), the mean gradient dropped from 49.6±21.2 mm Hg prior to dilation, to 15.3±15.8 mm Hg after the procedure (p>0.05). Twenty-six patients were recatheterized 3–24 months after the initial procedure. The mean gradient remained low at 12.7±15.2 mm Hg (range 0–64). Six of the 26 (23%) patients required a second dilation because of significant recoarctation. This proved successful in four, but in two patients, the second dilation failed, and they were referred for elective surgery. Thus, good overall results were obtained in 24 of the 26 (92.3%) patients undergoing reinvestigation following balloon dilation. Complications included requirements for blood transfusion in 9/44 (20%), chest pain during balloon inflation in 3/44 (6.8%), rupture of the balloon in 3/44 (6.8%), and femoral arterial thrombectomy in 3/44 (6.8%). At a mean clinical follow-up of 21 months, 21% of the patients had a weaker femoral pulse on the side used for balloon dilation, while 21% had mild hypertension measured in the arms despite the absence of a significant gradient. One patient (2.6%) developed an aortic aneurysm as a complication of the procedure. We conclude that balloon dilation is a safe and effective procedure in the majority of the patients with native aortic coarctation.

Keywords

Native aortic coarctationballoon dilationinterventional cardiac catheterization
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 2 , April 1994 , pp. 126 - 130
Copyright
Copyright © Cambridge University Press 1994

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