Author + information
- Received June 13, 1988
- Revision received October 12, 1988
- Accepted October 20, 1988
- Published online March 1, 1989.
- Jose Suarez De Lezo, MD∗,
- Manuel Sancho, MD,
- Manuel Pan, MD,
- Miguel Romero, MD,
- Carmen Olivera, MD and
- Manuel Luque, MD
- ↵∗Address for reprintsJosé Suárez de Lezo, MD, Servicio de Cardiología, Hospital “Reina Sofía”, Avda. Menéndez Pidal 1, 14004-Cordoba, Spain
Balloon angioplasty for coarctation of the aorta was performed in 45 patients; 17 (Group 1) were infants (mean age 34 ± 43 days). This study focuses on the remaining 28 patients (Group 2), children and adults ranging in age from 2 to 31 years (mean 13 ± 8). Two patients had had previous surgery for coarctation; in the remaining 26 the coarctation had not been surgically treated. Twenty patients (71%) had a discrete type of coarctation; the remaining eight had a diffuse or eccentric stenosis. Angiographic studies of the aorta were performed before and immediately after angioplasty in all 28 patients; 16 (57%) of them also underwent angiographic reevaluation 10 ± 2 months later.
The pressure gradient decreased immediately after angioplasty and was unchanged at follow-up. Residual gradient at follow-up ranged from 0 to 40 mm Hg (mean 11 ± 13). Patients with a discrete type of coarctation had a lesser residual gradient than did patients with other anatomic types of coarctation. Angiographically, the stenosis also decreased after angioplasty (68 ± 10% versus 24 ± 17%; p < 0.01); a new small, but significant decrease was observed at follow-up (9 ± 18%; p < 0.05).
A quantitative analysis of the aorta at different levels revealed no significant changes proximal and distal to the coarctation segment; however, at the level of coarctation, a significant (p < 0.01) and homogeneous increment was observed after dilation that was unchanged at follow-up. One (6%) of 16 reevaluated patients had a clear aneurysm at the site of dilation. In addition, changes in configuration of the aorta showing a tendency to realignment were observed and quantified by the change in configuration angle determined from the proximal and distal aortic segments (169 ± 17°). This angle did not change immediately after angioplasty, but increased significantly at follow-up (186 ± 17°, p < 0.05). These findings suggest that flow-dependent configuration changes can develop in the aorta after angioplasty.
- Received June 13, 1988.
- Revision received October 12, 1988.
- Accepted October 20, 1988.