Comparison of surgical repair with balloon angioplasty for native coarctation in patients from 3 months to 16 years of age.
OBJECTIVE
Surgery and balloon angioplasty (BA) for coarctation of the aorta have shown comparable short-term results, but long-term follow-up remains unclear. Comparison of surgical repair and balloon coarctation for native coarctation of the localised membranous form is performed retrospectively. To allow a valid comparison between both techniques, identical inclusion criteria were applied.


METHODS
Results of surgery (group A, 18 patients, age 0.30-14 years, median 0.63 years) and BA (group B, 28 patients, age 0.25-15 years, median 5.8 years) for isolated, native coarctation in children >3 months, performed in a 10-year-period, were compared. Kaplan-Meier analysis was performed in both groups. Mean follow-up ranged from 2.5 to 11 years (mean 7.2+/-2.4 years) in group A and from 1.4 to 10 years (mean 5.4+/-2.8 years) in group B.


RESULTS
Immediate success was obtained in all patients following surgery and 27/28 patients (96%) following BA. No statistical difference between surgery and angioplasty with respect to resultant pressure gradient decreases were found. Mortality was not encountered. Hospital stay varied from 6 to 20 days in group A and was 48 h for all patients in group B. Recoarctation occurred in one patient (5.6%) in group A and in two patients (7%) in group B. Log-rank test reveals no statistical difference in freedom from reintervention probabilities between surgery and angioplasty. Aneurysm formation was not encountered.


CONCLUSIONS
Both surgical repair and BA for native coarctation yield low reintervention probabilities in comparable patients. Aneurysm formation was not encountered following different treatment types.
Walhout
Ronald J
RJ
Children's Heart Center, UMC Utrecht, The Netherlands.
Lekkerkerker
Jaco C
JC
Oron
Gordon H
GH
Bennink
Ger B W E
GB
Meijboom
Erik J
EJ
D000293:Adolescent; D000800:Angioplasty, Balloon; D001013:Aorta, Thoracic / Q000503:physiopathology; D001017:Aortic Coarctation / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D011673:Pulsatile Flow; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome