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Balloon dilation for aortic recoarctation: morphology at the site of dilation and long-term efficacy

Published online by Cambridge University Press:  01 July 2011

Christian Mann ,
Georg Goebel ,
Andreas Eicken ,
Thomas Genz ,
Walter Sebening ,
Harald Kaemmerer ,
Ignaz Hammerer  and
John Hess
Christian Mann*
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital, Innsbruck
Georg Goebel
Affiliation:
Institute of Biostatistics and Documentation, Innsbruck, Austria
Andreas Eicken
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, München, Germany
Thomas Genz
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, München, Germany
Walter Sebening
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, München, Germany
Harald Kaemmerer
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, München, Germany
Ignaz Hammerer
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital, Innsbruck
John Hess
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, München, Germany
*
Correspondence to: Dr. C. Mann, Department of Pediatric Cardiology, University Children's Hospital, Anichstr. 35, A – 6020 Innsbruck, Austria. Tel: 0043 5522 43 13314; Fax: 0043 5522 43 1339; E-mail: chrimann@vol.at
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Abstract

Objectives: We undertook this study to assess the immediate and long-term outcome of balloon angioplasty performed for recurrent or residual coarctation of the aorta, and to assess the changes in the vessel wall caused by this procedure. Methods: Clinical, echocardiographic, angiographic and hemodynamic data from 71 patients who underwent balloon angioplasty for recoarctation between January 1987 and January 1998 were analysed retrospectively. Results: Angioplasty was performed after a median of 82.6 months (range 1.4 mo – 20.9 y, mean 88.5 mo) following surgery for coarctation. Mean systolic pressure gradients were reduced from 27±15 mmHg to 11 ± 11 m m Hg after angioplasty (p< 0.0001). The mean diameter at the site of recoarctation increased from 5.5±2.5 to 7.5±2.7 mm(p< 0.0001). Outpouchings of contrast agents, indicating the disruption of the inner layers of the vessel wall, were defined as extravasations. They were observed in one-quarter of the angiograms performed immediately after the intervention. Immediate success of angioplasty was achieved in 71%, and persisted in 69% of patients during long-term follow up. The main determinant for immediate success was the age at the time of the procedure (p<0.05), while the main determinant for long-term success was the increase achieved in diameter. Extravasations did not progress to aneurysms, neither acutely nor during echocardiographic follow-up studies. For further follow-up, more sensitive imaging techniques will be necessary to delineate the morphology of the site of extravasation observed immediately after angioplasty.

Keywords

Recoarctationballoon angioplastydeterminants of resultsextravasationsaneurysm.
Type
Original Articles
Information
Cardiology in the Young , Volume 11 , Issue 1 , January 2001 , pp. 31 - 35
Copyright
Copyright © Cambridge University Press 2001

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