title: Balloon angioplasty in aortic coarctation: a multicentric study in Mexico.
abstract: 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.
authors.affiliation: Hospital General Centro Médico Nacional La Raza, IMSS, México D.F.
authors.forename: Jaime
authors.initials: J
authors.lastname: Munayer Calderón
authors.forename: Carlos
authors.initials: C
authors.lastname: Zabal Cerdeira
authors.forename: Mariano
authors.initials: M
authors.lastname: Ledesma Velazco
authors.forename: Tomás
authors.initials: T
authors.lastname: Aldana Pérez
authors.forename: Homero
authors.initials: H
authors.lastname: Ramírez Reyes
authors.forename: José Luis
authors.initials: JL
authors.lastname: Lázaro Castillo
authors.forename: Fause
authors.initials: F
authors.lastname: Attie
authors.forename: Carlos
authors.initials: C
authors.lastname: Alva Espinoza
authors.forename: Alfonso
authors.initials: A
authors.lastname: Buendía Hernández
authors.forename: David
authors.initials: D
authors.lastname: Jiménez Zepeda
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Martínez Ríos
authors.forename: Santiago
authors.initials: S
authors.lastname: Jiménez Arteaga
authors.forename: Raúl San
authors.initials: RS
authors.lastname: Luis Miranda
authors.forename: Juan
authors.initials: J
authors.lastname: Calderón Colmenero
authors.forename: Arturo
authors.initials: A
authors.lastname: Martínez Sánchez
authors.forename: Gerardo
authors.initials: G
authors.lastname: Maza Juárez
authors.forename: Felipe David
authors.initials: FD
authors.lastname: Gómez
authors.forename: José
authors.initials: J
authors.lastname: Ortegón Cárdenas
authors.forename: José Antonio
authors.initials: JA
authors.lastname: García Montes
authors.forename: Luis Roberto
authors.initials: LR
authors.lastname: Quintero
authors.forename: Arturo
authors.initials: A
authors.lastname: Campos Gómez
authors.forename: Agustín
authors.initials: A
authors.lastname: Sánchez Soberanes
mesh_terms: 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