Long-Term Outcomes of Native Coarctation of the Aorta after Balloon Angioplasty or Surgical Aortoplasty in Newborns and Young Infants Less Than 3 Months of Age.
BACKGROUND
Balloon angioplasty of native coarctation of the aorta, though effective, is frequently associated with early restenosis, repeated interventions and aneurysm formation, especially in very young patients. However, available long-term data are limited.


METHODS
From Jan. 1986 to Dec. 2007, eighty-eight patients with simple aortic coarctation, isolated or associated with patent ductus arteriosus or ventricular septal defect, and survived angioplasty (n = 17) or surgery (n = 71) within 3 months of age in National Taiwan University Hospital were enrolled.


RESULTS
The average length of follow-up was 10.1 ± 5.1 years. The long-term outcomes between these two groups were comparable in hypertension, left ventricular outflow tract obstruction, and aortic aneurysm. Patients in the angioplasty group had a greater likelihood of reintervention (64.7% vs. 42.3%, p = 0.096) and repeated reintervention (29.4% vs. 7.0%, p = 0.027) as compared with surgery group. The 10-year freedom from reintervention was 35.3% and 59.2% in the angioplasty and surgery group, respectively (p = 0.046); there were no deaths reported in that 10-year span. Patients with angioplasty and those with patent ductus arteriosus were more likely to require surgical aortoplasty at reintervention.


CONCLUSIONS
The long-term outcomes of aortic coarctation in newborns and young infants after balloon angioplasty were effective and beneficial. However, those outcomes were accompanied by concomitant higher risks of reintervention and surgical reintervention, particularly in those with patent ductus arteriosus.


BACKGROUND
Aortic operation; Coarctation; Infant; Outcomes.
Department of Pediatrics, National Taiwan University Hospital, Taipei; ; Department of Pediatrics, National Taiwan University Hospital, Yun-Lin branch, Yun-Lin;
Hsin-Hui
HH
Chiu
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Jou-Kou
JK
Wang
Department of Surgery, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan.
Yih-Shang
YS
Chen
Department of Surgery, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan.
Ing-Sh
IS
Chiu
Department of Surgery, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan.
Chung-I
CI
Chang
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Ming-Tai
MT
Lin
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Chun-Wei
CW
Lu
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Shuenn-Nan
SN
Chiu
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Chun-An
CA
Chen
Department of Pediatrics, National Taiwan University Hospital, Taipei;
Mei-Hwan
MH
Wu