Balloon angioplasty of recurrent coarctation: A 12-year review

Anji T. Yetman, David Nykanen, Brian W. McCrindle, Jan Sunnegardh, Ian Adatia, Robert M. Freedom, Lee Benson

Research output: Contribution to journalReview article

122 Citations (Scopus)

Abstract

Objectives. This study was undertaken to investigate the long-term outcome of balloon angioplasty for recurrent coarctation of the aorta in a large series of patients. Background. Balloon angioplasty has become the standard treatment for residual or recurrent aortic coarctation. Despite the widespread use of this treatment modality, there are few data outlining the long-term outcome of a large patient cohort. Methods. Clinical, echocardiographic, hemodynamic and angiographic data on 90 consecutive patients who underwent balloon angioplasty between January 1984 and January 1996 were reviewed. Results. Mean systolic pressure gradients were reduced from 31 ± 21 to 8 ± 9 mm Hg after dilation (p = 0.0001). The mean diameter of the stenotic site, measured in the frontal and lateral views, increased by 38% and 35%, respectively (p = 0.001). Neurologic events occurred in two patients, with one death an aortic tear occurred in one patient, requiring surgical intervention. Optimal results were defined as a postprocedure gradient <20 mm Hg and were obtained acutely in 88% of patients. At long- term follow-up (12 years), 53 (72%) of 74 patients with an early optimal result remained free from reintervention. Transverse arch hypoplasia, defined as an arch dimension <2 SD below the mean for age, was the primary predictor of the need for reintervention. Conclusions. Although the majority of patients undergoing percutaneous balloon angioplasty for recoarctation of the aorta will achieve long-term benefit, the need for further surgical intervention in those with transverse arch hypoplasia remains high.

Original languageEnglish (US)
Pages (from-to)811-816
Number of pages6
JournalJournal of the American College of Cardiology
Volume30
Issue number3
DOIs
StatePublished - Jul 1997

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compound A 12
Balloon Angioplasty
Aortic Coarctation
Tears
Nervous System
Aorta
Dilatation
Hemodynamics
Blood Pressure
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yetman, A. T., Nykanen, D., McCrindle, B. W., Sunnegardh, J., Adatia, I., Freedom, R. M., & Benson, L. (1997). Balloon angioplasty of recurrent coarctation: A 12-year review. Journal of the American College of Cardiology, 30(3), 811-816. https://doi.org/10.1016/S0735-1097(97)00228-3

Balloon angioplasty of recurrent coarctation : A 12-year review. / Yetman, Anji T.; Nykanen, David; McCrindle, Brian W.; Sunnegardh, Jan; Adatia, Ian; Freedom, Robert M.; Benson, Lee.

In: Journal of the American College of Cardiology, Vol. 30, No. 3, 07.1997, p. 811-816.

Research output: Contribution to journalReview article

Yetman, AT, Nykanen, D, McCrindle, BW, Sunnegardh, J, Adatia, I, Freedom, RM & Benson, L 1997, 'Balloon angioplasty of recurrent coarctation: A 12-year review', Journal of the American College of Cardiology, vol. 30, no. 3, pp. 811-816. https://doi.org/10.1016/S0735-1097(97)00228-3
Yetman, Anji T. ; Nykanen, David ; McCrindle, Brian W. ; Sunnegardh, Jan ; Adatia, Ian ; Freedom, Robert M. ; Benson, Lee. / Balloon angioplasty of recurrent coarctation : A 12-year review. In: Journal of the American College of Cardiology. 1997 ; Vol. 30, No. 3. pp. 811-816.
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AB - Objectives. This study was undertaken to investigate the long-term outcome of balloon angioplasty for recurrent coarctation of the aorta in a large series of patients. Background. Balloon angioplasty has become the standard treatment for residual or recurrent aortic coarctation. Despite the widespread use of this treatment modality, there are few data outlining the long-term outcome of a large patient cohort. Methods. Clinical, echocardiographic, hemodynamic and angiographic data on 90 consecutive patients who underwent balloon angioplasty between January 1984 and January 1996 were reviewed. Results. Mean systolic pressure gradients were reduced from 31 ± 21 to 8 ± 9 mm Hg after dilation (p = 0.0001). The mean diameter of the stenotic site, measured in the frontal and lateral views, increased by 38% and 35%, respectively (p = 0.001). Neurologic events occurred in two patients, with one death an aortic tear occurred in one patient, requiring surgical intervention. Optimal results were defined as a postprocedure gradient <20 mm Hg and were obtained acutely in 88% of patients. At long- term follow-up (12 years), 53 (72%) of 74 patients with an early optimal result remained free from reintervention. Transverse arch hypoplasia, defined as an arch dimension <2 SD below the mean for age, was the primary predictor of the need for reintervention. Conclusions. Although the majority of patients undergoing percutaneous balloon angioplasty for recoarctation of the aorta will achieve long-term benefit, the need for further surgical intervention in those with transverse arch hypoplasia remains high.

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