title: Balloon angioplasty of native coarctation of the aorta in adolescents and young adults.
abstract: Balloon angioplasty of native coarctation of the aorta was performed in 35 consecutive adolescents and young adults, aged 14 to 37 years (mean 22.6 +/- 7.1). Twenty-eight (80%) patients had isolated discrete coarctation, six (17.1%) had tubular hypoplasia of the aortic isthmus, and one (2.9%) had hypoplasia of the post-coarctation aorta. The peak systolic pressure gradient decreased from 78.5 +/- 23.9 to 15.7 +/- 11.6 mm Hg (p less than 0.001), and the mean coarctation diameter increased from 4.7 +/- 2.4 to 13.1 +/- 2.7 mm (p less than 0.001) immediately after angioplasty. Patients with discrete-type coarctation had significantly less residual gradient than patients with long-segment tubular coarctation (12.3 +/- 10.7 vs 27.2 +/- 6.6 mm Hg, p less than 0.01). On recatheterization and angiography in 26 patients at 12.6 +/- 1.5 months after dilatation, there was no significant change in gradient (15.5 +/- 13.3 mm Hg) and diameter (13.1 +/- 1.8 mm) from the immediate post-angioplasty results. However, two patients had an increase in gradient and three had small aortic aneurysms with no change in appearance on restudy after 2 years. After 3 to 67 months' (mean 32.7 +/- 19.2) follow-up, all patients showed continued clinical improvement. Hypertension was relieved in 37.5% (12/32) and improved in 59.4% (19/32). Our experience suggests that balloon angioplasty of native aortic coarctation in adolescents and young adults is safe and highly effective with sustained improvement on intermediate-term follow-up.
authors.affiliation: Department of Cardiology, G. B. Pant Hospital, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Tyagi
authors.forename: R
authors.initials: R
authors.lastname: Arora
authors.forename: U A
authors.initials: UA
authors.lastname: Kaul
authors.forename: K K
authors.initials: KK
authors.lastname: Sethi
authors.forename: D S
authors.initials: DS
authors.lastname: Gambhir
authors.forename: M
authors.initials: M
authors.lastname: Khalilullah
mesh_terms: D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D011859:Radiography; D013997:Time Factors