Balloon dilatation of native coarctation of aorta in infants - short term clinical result

  • Dr. Nilesh Oswal U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Dr. Dhaval Doshi U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Dr. Nikhil Jadhav U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Dr. Dhammdeep Humane U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Dr.Kamal Sharma U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Dr. Komal Shah U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Ahmedabad, Gujarat, India
Keywords: Coarctation of aorta, Balloon angioplasty, Infants

Abstract

Background: Balloon dilatation with or without placement of stent in native coarctation offers a good alternative to surgery.

Aim: To determine feasibility and safety of primary balloon angioplasty in infants with coarctation of aorta.

Materials and Methods: This was a retrospective, observational study of 44 consecutive infants undergoing balloon dilatation of native coarctation of aorta during a 4 year period from July 2009 to July 2013. Demographic details, previous history and data of chest X-ray, electrocardiogram and sequential echocardiography were collected for all the patients. The patients were followed up at 1 months, 6 months and 1 year thereafter.

Results: The reintervention rate was 20.45% after successful procedure. Two patients having hypoplastic arch had successful procedure with 1 requiring reintervention. Left ventricular dysfunction was observed in 15 patients, out of them 11 patients improved immediately after the procedure. Thirty five (79.55%) patients did not undergo reintervention in whom mean gradient was reduced from 48.05±15.26 mm Hg to 10.97±5.8 mm Hg after percutaneous reintervention (p<0.0001). Also, mean diameter in this group was improved (1.94±0.52 vs 6.07±1.84 mm; p <0.0001). Early age of presentation was identified as a contributor of reintervention in the study population (p=0.009).

Conclusions: This study results show that BDC in infants is a safe and feasible technique that could be effectively used as an option of surgery in order to reduce mortality and morbidity.

Downloads

Download data is not yet available.

References

1. Jenkins NP, Ward C. Coarctation of the aorta: natural history and outcome after surgical treatment. QJM 1999; 92(7):365-71. [PubMed]

2. Wong D, Benson LN, Van Arsdell GS, Karamlou T, McCrindle BW. Balloon angioplasty is preferred to surgery for aortic coarctation. Cardiol. Young 2008; 18(1):79–88. DOI: 10.1017/S1047951107001795.

3. Lock JE, Castaneda-Zuniga WR, Bass JL, Foker JE, Amplatz K, Anderson RW. Balloon dilatation of excised aortic coarctations. Radiology. 1982; 143(3):689-91. DOI: 10.1148/radiology.143.3.6210934. [PubMed]

4. Hijazi ZM, Fahey JT, Kleinman CS, Hellenbrand WE. Balloon angioplasty for recurrent coarctation of aorta. Immediate and long-term results. Circulation 1991; 84(3): 1150-56. DOI: https://doi.org/10.1161/01.CIR.84.3.1150. [PubMed]

5. Ovaert C, McCrindle BW, Nykanen D, MacDonald C, Freedom RM, Benson LN.. Balloon angioplasty of native coarctation: clinical outcomes and predictors of success. J Am Coll Cardiol. 2000; 35(4): 988-96. DOI: http://dx.doi.org/10.1016/S0735-1097(99)00646-4.

6. Hamdan MA, Maheshwari S, Fahey JT, Hellenbrand WE. Endovascular stents for coarctation of the aorta: initial results and intermediate-term follow-up. J Am Coll Cardiol. 2001; 38(5):1518-23. DOI: http://dx.doi.org/10.1016/S0735-1097(01)01572-8.

7. Freed MD, Heymann MA, Lewis AB, Roehl SL, Kensey RC. Prostaglandin E1 infants with ductus arteriosus-dependent congenital heart disease. Circulation 1981; 64(5):899-905. DOI: https://doi.org/10.1161/01.CIR.64.5.899.

8. Yetman AT, Nykanen D, McCrindle BW, Sunnegardh J, Adatia I, Freedom RM, Benson L. Balloon angioplasty of recurrent coarctation. J Am Card. 1997; 30(3):811–16. DOI: http://dx.doi.org/10.1016/S0735-1097(97)00228-3.

9. Mohammed Farouk, Ahmed El Ayadi, Sonia El Saeidy. Improvement of Left Ventricular Mass Following Balloon Angioplasty of Native Coarctation of the Aorta: Midterm follow-up in Cairo University, Children’s Hospital. Br J Med Med Res. 2013; 3(4): 1271-84. DOI: 10.9734/BJMMR/2013/3262.

10. Rao PS. Balloon angioplasty for coarctation of the aorta in infancy. J Pediatr. 1987; 110(5):713-18. [PubMed]

11. Redington AN, Booth Phillip, Shore DF, Rigby ML. Primary balloon dilatation of coarctation of the aorta in neonates. Br Heart J. 1990; 64(4):277–81. [PubMed]

12. Rao PS. Balloon angioplasty of native coarctation of the aorta. J. Invasive Cardiol. 2000; 12(8):407–9. [PubMed]

13. Ohkubo M, Takahashi K, Kishiro M, Akimoto K, Yamashiro Y. Histological findings after angioplasty using conventional balloon, radiofrequency thermal balloon, and stent for experimental aortic coarctation. Pediatr Int. 2004; 46(1):39–47. DOI: 10.1111/j.1328-0867.2004.t01-1-.x

14. Beekman RH, Rocchini AP, Dick M 2nd, Snider AR, Crowley DC, Serwer GA, Spicer RL, Rosenthal A. Percutaneous balloon angioplasty for native coarctation of the aorta. J Am Coll Cardiol. 1987; 10(5):1078–84. [PubMed]

15. Oleg Reich, Petr Tax, Helena Bartáková, Viktor Tomek, Jiří Gilík, Jiří Lisý, Jiří Radvanský, Tomáš Matějka, Tomáš Tláskal, IrenaSvobodová, Václav Chaloupecký, Jan Škovránek. Long-term (up to 20 years) results of percutaneous balloon angioplasty of recurrent aortic coarctation without use of stents: Eur Heart J. 2008; 29(16): 2042–48 DOI: http://dx.doi.org/10.1093/eurheartj/ehn251.

16. Kaine SF, O’Brian Smith E, Mott AR, Mullins CE, Geva T. Quantitative echocardiographic analysis of the aortic arch predicts outcome of balloon angioplasty of native coarctation of the aorta. Circulation. 1996; 94(5):1056–62. https://doi.org/10.1161/01.CIR.94.5.1056

17. Erbel R, Gorge G, Gerber T, Ge J, Thelen M, Rumpelt HJ, et al. Dissection following balloon angioplasty of aortic coarctation: review of the literature. J Interv Cardiol. 1992; 5(2):99–109. DOI: 10.1111/j.1540-8183.1992.tb00414.x

18. Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Bonow RO, Mann DL, Zipes DP, and Libby P (eds). Braunwald's Heart Disease: A textbook of cardiovascular medicine, 9th edition. Philadelphia, WB Saunders. 2011; 65:1412-67. [PubMed]

19. Maheshwari S, Bruckheimer E, Fahey JT, Hellenbrand WE. Balloon angioplasty of postsurgical recoarctation in infants: the risk of restenosis and long-term follow-up. J Am Coll Cardiol. 2000; 35(1):209-13. DOI: http://dx.doi.org/10.1016/S0735-1097(99)00527-6. [PubMed]
Balloon dilatation of native coarctation of aorta in infants - short term clinical result
CITATION
DOI: 10.17511/ijpr.2017.i01.11
Published: 2017-01-31
How to Cite
Dr. Nilesh Oswal, Dr. Dhaval Doshi, Dr. Nikhil Jadhav, Dr. Dhammdeep Humane, Dr.Kamal Sharma, & Dr. Komal Shah. (2017). Balloon dilatation of native coarctation of aorta in infants - short term clinical result. Pediatric Review: International Journal of Pediatric Research, 4(1), 52-57. https://doi.org/10.17511/ijpr.2017.i01.11
Section
Original Article