Balloon angioplasty in aortic coarctation: a multicentric study in Mexico.
OBJECTIVE
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 = 0.0001), 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.
Munayer Calderón
Jaime
J
Hospital General Centro Médico Nacional La Raza, IMSS, México D.F.
Zabal Cerdeira
Carlos
C
Ledesma Velazco
Mariano
M
Aldana Pérez
Tomás
T
Ramírez Reyes
Homero
H
Lázaro Castillo
José Luis
JL
Attie
Fause
F
Alva Espinoza
Carlos
C
Buendía Hernández
Alfonso
A
Jiménez Zepeda
David
D
Martínez Ríos
Marco Antonio
MA
Jiménez Arteaga
Santiago
S
Luis Miranda
Raúl San
RS
Calderón Colmenero
Juan
J
Martínez Sánchez
Arturo
A
Maza Juárez
Gerardo
G
Gómez
Felipe David
FD
Ortegón Cárdenas
José
J
García Montes
José Antonio
JA
Quintero
Luis Roberto
LR
Campos Gómez
Arturo
A
Sánchez Soberanes
Agustín
A
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D001017:Aortic Coarctation / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D008875:Middle Aged