[Balloon angioplasty for native coarctation in children: immediate and medium-term results].
OBJECTIVE
The use of balloon angioplasty to treat native aortic coarctation in pediatric patients is controversial. Our aims were to report our experience with this technique and to compare retrospectively the immediate and medium-term results obtained during 2 distinct time periods.


METHODS
53 patients who underwent balloon angioplasty for native coarctation were divided into 2 groups: (A) those treated between 1985-1988 (n=26); and (B) those treated between 1993-2003 (n=27). Follow-up data were available for all patients.


RESULTS
The immediate result was good (i.e., pressure gradient, <20 mmHg) in 18/26 patients in group A (69.2%) and 22/27 (81.5%) in group B. On follow-up, the recoarctation rate was similar in both groups: 33% in group A and 25.6% in group B. Group A patients with recoarctation were referred for surgery, whereas group B patients underwent a second angioplasty (either balloon or stent). At the end of follow-up, angioplasty had been successful in 62% (16/26) of patients in group A vs 85% (23/27) in group B. The incidence of serious complications was lower in group B (4%) than group A (19.2%), as was the incidence of aneurysm: 4% in group B vs 15% in group A.


CONCLUSIONS
Balloon angioplasty is an effective alternative to surgery for the treatment of native, localized aortic coarctation. Better selection of suitable patients, use of low-profile catheters, and improved patient care can reduce the incidence of complications. Repeat angioplasty (either balloon or stent) in cases of recoarctation has improved results with this technique.
del Cerro
María J
MJ
Servicio de Cardiología Pediátrica, Hospital Infantil La Paz, Madrid, Spain. mcerro.hulp@salud.madrid.org
Fernández-Ruiz
Aurora
A
Benito
Fernando
F
Rubio
Dolores
D
Castro
María C
MC
Moreno
Felipe
F
D000293:Adolescent; D000800:Angioplasty, Balloon; D001017:Aortic Coarctation / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018579:Patient Selection; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome