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Percutaneous Angioplasty Used to Manage Native and Recurrent Coarctation of the Aorta in Infants Younger than 1 Year: Immediate and Midterm Results

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Abstract

Balloon angioplasty (BAP) used to manage native coarctation of the aorta (CoAo) in infants remains controversial. This study aimed to compare short- and midterm results of BAP between native CoAo (NaCo) and postsurgical recoarctations (ReCo) in infants younger than 1 year. This retrospective study compared the clinical, echocardiographic, hemodynamic, and angiographic data for infants who underwent BAP between July 2003 and September 2012. The 12 NaCo and 13 ReCo patients in this study underwent BAP at 4.61 ± 3.69 and 4.88 ± 3.07 months (p = 0.84) and weighed 5.49 ± 2.57 and 6.10 ± 2.11 kg (p = 0.52), respectively. Their respective heights were 60.58 ± 10.58 and 61.15 ± 6.74 cm (p = 0.87). All the ReCo patients had their initial surgery before the age of 3 months. The minimal CoAo diameter was 2.81 ± 0.96 mm in the NaCo group and 2.86 ± 1.0 mm in the ReCo group (p = 0.90). The relative gradient reduction was 62.79 ± 32.43 % in the NaCo group and 73.37 ± 20.78 % in the ReCo group (p = 0.33). The in situ complication rate (pseudoaneurysm) was 8.33 % in the NaCo group and 7.69 % in the ReCo group (p = 0.74). During the early follow-up evaluation, five NaCo patients (41.66 %) presented with recoarctation requiring BAP reintervention within 1.75 ± 1.41 months (all had their initial BAP before 3 months of age) compared with 1 ReCo patient (7.69 %) (p = 0.165). The mean follow-up period was 3.09 ± 2.69 years for the NaCo patients and 3.6 ± 3.18 years for the ReCo patients (p = 0.69), during which the blood pressure gradient was 12.33 ± 9.67 for the NaCo patients and 7.80 ± 8.78 for the ReCo patients (p = 0.17), with corresponding Doppler peak instantaneous gradients of 21.29 ± 11.19 and 16.20 ± 10.23 (p = 0.24). The resultant diameter ratio between the minimal isthmus diameter and the aortic diameter at the diaphragmatic level was 0.81 ± 0.15 in the NaCo group and 0.85 ± 0.12 in the ReCo group (p = 0.53). The immediate and midterm results of BAP for the NaCo and ReCo infants were comparable. Accordingly, BAP seems to be an acceptable alternative to surgery for infants older than 3 months.

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Acknowledgments

Philippe Mahouna ADJAGBA (PMA) was supported by scholarships from Programme de Jumelage de Fonds, CHU Ste-Justine.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, CHU Sainte-Justine, University of Montreal, 3175 Côte Ste-Catherine, Montreal, QC, H3T 1C5, Canada

    Philippe Mahouna Adjagba, Baher Hanna, Joaquim Miró & Nagib Dahdah

  2. Department of Cardiology, Hopital de la Mère et de l’Enfant-Lagune (HOMEL), Cotonou, Benin

    Philippe Mahouna Adjagba

  3. Department of Pediatric Cardiology, Aswan Heart Center, Aswân, Egypt

    Baher Hanna

  4. Division of Pediatric Cardiology, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada

    Adrian Dancea

  5. Division of Pediatric Cardiothoracic Surgery, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Nancy Poirier & Suzanne Vobecky

  6. Department of Radiology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Julie Déry & Chantale Lapierre

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  1. Philippe Mahouna Adjagba
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  2. Baher Hanna
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  9. Nagib Dahdah
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Correspondence to Nagib Dahdah.

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Adjagba, P.M., Hanna, B., Miró, J. et al. Percutaneous Angioplasty Used to Manage Native and Recurrent Coarctation of the Aorta in Infants Younger than 1 Year: Immediate and Midterm Results. Pediatr Cardiol 35, 1155–1161 (2014). https://doi.org/10.1007/s00246-014-0909-3

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