Kafalı, Gülden Bilim Üniversitesi - Avrupa Florence Nightingale Eğitim ve Araştırma Hastanesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Kardiyoloji Ünitesi, Turkey , Bilgiç, Arman Hacettepe Üniversitesi - Tıp Fakültesi - Çocuk Kardiyoloji Bilim Dalı, Turkey , Çeliker, Alpay Acıbadem Üniversitesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Kardiyoloji Ünitesi, Turkey

Follow-up Results and Complications of Balloon Angioplasty in Children with Native Coarctation

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Objective: Balloon angioplasty (BA) is controversial in infants and children with native coarctation because it has the potential risk of complications and recoarctation. We evaluated 31 children with native coarctation by control angiography after 29±18 months. Methods: The patients were separated as successful follow-up and reintervention groups. All data before and after BA were compared in these groups. The possibility of whether elastic properties of the coarcted segment, hypoplasia of aortic segments and, the presence of a patent ductus arteriosus (PDA) are risk factors or not in the reintervention was investigated. Complications were recorded. Results: The patients’ average age at procedure were 2.9±3.7 years. Twenty nine patients (93.5%) had discrete coarctation and 5 patients (16%) had PDA. Balloon angioplasty was successful in 29 patients (94%). As a result of control angiography, 2 patients with increased residual gradient and 9 who developed recoarctation were the reintervention group (35.5%). Twenty patients (64.5%) were the successful follow-up group. Balloon half diameter and circumference stretch percent of the successful group were significantly higher (p 0.05). Ductal patent and the lower circumference stretch percent were found with decreasing reintervention duration. Freedom from reintervention was 80% at 1 year and 55% after 38 months. Conclusions: Balloon angioplasty is superior to surgery with regard to complications, mortality, hospitalisation duration and cost in all children with native coarctation. However, gradually decreasing freedom from reintervention might be due to a mechanism which causes progressive vascular remodeling and smooth muscle cell proliferation. Further investigations should be carried out to prove this relationship.

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Native coarctation , balloon angioplasty , aneurysm , recoarctation

Fırat Medical Journal

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