medigraphic.com

2002, Number 1

<< Back Next >>

Arch Cardiol Mex 2002; 72 (1)

Balloon angioplasty in aortic coarctation: a multicentric study in Mexico

Munayer CJ, Zabal CC, Ledesma VM, Aldana PT, Ramírez RH, Lázaro CJL, Attie F, Alva EC, Buendía HA, Jiménez ZD, Martínez RMA, Jiménez AS, San LMR, Calderón CJ, Martínez SA, Maza JG, David GF, Ortegón CJ, García MJA, Quintero LR, Campos GA, Sánchez SA

Language: English
References: 18
Page: 20-28
PDF size: 109.52 Kb.


ABSTRACT

Objectives: To analyze immediate and long-term results of balloon dilation for aortic coarctation in a three-center experience in Mexico, and to determine factors associated with increased risk. Background: Results demonstrated that the procedure is effective and safe, however its use in some groups is still controversial, specially in neonates and infants. Methods: In a ten-year period, 333 patients with aortic coarctation on underwent balloon dilation with an immediate success rate of 93.7% and a major complication incidence of 1.8%. Of the total cohort, 272 patients were followed for a period of 24.3 ± 20 months. Demographic and procedural data were analyzed to determine factors related to a poor outcome or to sustained high blood pressure. Results: Cox regression analysis found age (risk ratio 3.42 p = 0.000l), isthmic hypoplasia (risk ratio 4.64, p ‹ 0.0001), and post-dilation gradient (risk ratio 2.19, p = 0.0113) as independent risk factors for a follow-up event, mainly restenosis. Age at dilation was the only independent factor related to sustained hypertension with a seven-fold increase in the risk. Conclusions: Balloon dilation is an effective and safe alternative to treat aortic coarctation. Patients younger than one year of age, with severe isthmic hypoplasia and a post-dilation gradient › 20 mmHg have the highest risk to develop an event in the follow-up period. When the dilation procedure is performed in patients older than 10 years of age, and specially those older than 20 years, the probability that they remain or develop high blood pressure is increase.


REFERENCES

  1. Singer MI, Rowen M, Dorsey TJ: Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn. Am Heart J 1982; 103: 131-134.

  2. Sperling DR, Dorsey TJ, Rowen M, Gazzaniga AB: Percutaneous transluminal angioplasty of congenital coarctation of the aorta. Am J Cardiol 1983; 51: 562-564.

  3. Lababidi Z, Daskalopoulos DA, Stoeckle P IR. Transluminal balloon coarctation angioplasty: experience in 27 patients. Am J Cardiol 1984; S4: 1288-1291.

  4. Rao PS, Najjar HN, Mardini MK, Solymar L, Thapar MK: Balloon angioplasty for coarctation of the aorta: immediate and long-term results. Am Heart J 1988; 115: 657-664.

  5. Morrow WR, Vick III GW, Nihill MR, Rokey R, Johnston DL, Hedrick TD, Mullins CE: Balloon dilation of unoperated coarctation of the aorta: Short- and intermediate-term results. J Am Coll Cardiol 1988; 11: 133-138.

  6. Rao PS, Thapar MK, Kutayli F, Carey P: Causes of recoarctation after balloon angioplasty of unoperated aortic coartaction. J Am Coll Cardiol 1989; 13: 109-115.

  7. Cooper SG, Sullivan ID, Wren C: Treatment of recoarctation: balloon dilation angioplasty. J Am Coll Cardiol 1989; 14: 413-419.

  8. Tynan M, Finley JP, Fontes V, Hess J, Kan J: Balloon angioplasty for treatment of native coarctation: results of valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 790-792.

  9. Fontes VF, Esteves CA, Braga SLM, Da Silva MVD, E Silva MAP, Sousa JEMR, De Souza JAM: It is valid to dilate native aortic coarctation with a balloon catheter. Int J Cardiol 1990; 27: 311-316.

  10. Hellenbrand WE, Allen HD, Golinko RJ, Hagler DJ, Lutin W, Kan J: Balloon angioplasty for aortic recoarctation: results of valvuloplasty and angyoplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 793-797.

  11. Rothman A: Interventional therapy for coarctation of the aorta. Curr Opin Cardiol 1998; 13: 66-72.

  12. McCrindle BW, Jones TK, Morrow WR, Hagler DJ, Lloyd TR, Nouri S, Latson LA: Acute results of balloon angioplasty of native coarctation versus recurrent aortic obstruction are equivalent. Valvuloplasty and angioplasty of congenital anomalies (VACA) Registry investigators. J Am Coll Cardiol 1996; 28: 1810-7.

  13. Rao PS: Transcatheter treatment of pulmonary stenosis and coarctation of the aorta: experience with percutaneous balloon dilatation. Br Heart J 1986; 56: 250-8.

  14. Rao PS: Balloon angioplasty for coarctation of the aorta in infancy. J Pediatr 1987; 110: 713-8.

  15. Rao PS, Thapar MK, Galal O, Wilson AD: Follow-up results of balloon angioplasty of native coarctation in neonates and infants. Am Heart J 1990; 120: 1310-4.

  16. Rao PS, Galal O, Smith PA, Wilson AD: Five to nine-year follow-up results of balloon angioplasty of native aortic coarctation in infants and children. J Am Coll Cardiol 1996; 27(2): 462-70.

  17. Park Y, Lucas VW, Sklansky MS, Kashani IA, Rothman A: Balloon angioplasty of native aortic coarctation in infants 3 months of age and younger. Am Heart J 1997; 134(5 Pt-1): 917-23.

  18. Rao PS, Koscik R: Validation of risk factors in predicting recoarctation after initially successful ballon angioplasty for native aortic coarctation. Am Heart J 1995; 130: 116-21.




2020     |     www.medigraphic.com