Balloon Angioplasty for Native Coarctation of the Aorta in Children: Immediate Outcome and Follow-up for Heart Function

Background: The effect of balloon angioplasty in treatment of coarctation of the aorta (COA) in pediatric patients is very important.
Objectives: This study aimed to assess the efficacy and safety of balloon angioplasty for coarctation of the aorta (CoA) and its effects on heart function in children above 3 months of age.
Patients and Methods: In this retrospective study, we reviewed the immediate outcomes of 100 consecutive pediatric patients above 3 months of age with native CoA who were treated by balloon angioplasty at a tertiary pediatric heart center from June 2002 to August 2012. The patients were followed by echocardiography. Statistical analyses were performed by descriptive statistics using the SPSS statistical software, version 20 and the significance level was set at 0.05.
Results: The patients’ ages ranged from 4 months to 15 years, with the mean of 51.56 ± 42.22 months. Additionally, their body weight ranged from 4 to 63 kg (mean: 15.44 ± 10.62 kg) at the time of CoA repair. Technical success of balloon dilation was achieved in 91/95 patients (95.7%). Besides, systolic gradient significantly reduced from 48.29 ± 21.62 mmHg (range 7 - 82 mmHg) to 13.21 ± 9.96 mmHg (range 0 - 34 mmHg) (P < 0.0001). The mean follow-up period was 2.21 ± 0.94 years. Recoarctation and cardiac dysfunction occurred only in 4 patients. Z-scores of the Left Ventricular (LV) end diastolic and systolic dimensions were more than 2 standard deviations in 15 (17.1%) and 22 (25%) patients, respectively. In addition, there were 16 children (18.8%) with abnormal E/A ratios and 6 ones (6.8%) with E/Ea > 15.
Conclusions: Percutaneous balloon angioplasty was a safe and effective treatment option for native CoA in the children above 3 months old. However, impairment of LV diastolic function should be mentioned as an important issue in long-term follow-up.