Balloon angioplasty in aortic coarctation: a multicentric study in Mexico.

Abstract

OBJECTIVES:

To analyze immediate and long-term results of balloon dilation for aortic coarctation in a three-center experience in Mexico, and to determine factors associated with increased risk.

BACKGROUND:

Results demonstrated that the procedure is effective and safe, however its use in some groups is still controversial, specially in neonates and infants.

METHODS:

In a ten-year period, 333 patients with aortic coarctation on underwent balloon dilation with an immediate success rate of 93.7% and a major complication incidence of 1.8%. Of the total cohort, 272 patients were followed for a period of 24.3 +/- 20 months. Demographic and procedural data were analyzed to determine factors related to a poor outcome or to sustained high blood pressure.

RESULTS:

Cox regression analysis found age (risk ratio 3.42 p = 0.0001), isthmic hypoplasia (risk ratio 4.64, p < 0.0001), and post-dilation gradient (risk ratio 2.19, p = 0.0113) as independent risk factors for a follow-up event, mainly restenosis. Age at dilation was the only independent factor related to sustained hypertension with a seven-fold increase in the risk.

CONCLUSIONS:

Balloon dilation is an effective and safe alternative to treat aortic coarctation. Patients younger than one year of age, with severe isthmic hypoplasia and a post-dilation gradient > 20 mmHg have the highest risk to develop an event in the follow-up period. When the dilation procedure is performed in patients older than 10 years of age, and specially those older than 20 years, the probability that they remain or develop high blood pressure is increase.

• Authors: Jaime Munayer Calderón, Carlos Zabal Cerdeira, Mariano Ledesma Velazco, Tomás Aldana Pérez, Homero Ramírez Reyes, José Luis Lázaro Castillo, Fause Attie, Carlos Alva Espinoza, Alfonso Buendía Hernández, David Jiménez Zepeda, Marco Antonio Martínez Ríos, Santiago Jiménez Arteaga, Raúl San Luis Miranda, Juan Calderón Colmenero, Arturo Martínez Sánchez, Gerardo Maza Juárez, Felipe David Gómez, José Ortegón Cárdenas, José Antonio García Montes, Luis Roberto Quintero, Arturo Campos Gómez, Agustín Sánchez Soberanes
• Journal: Archivos de cardiologia de Mexico (Arch Cardiol Mex) Vol. 72 Issue 1 Pg. 20-8 ( 2002) ISSN: 1405-9940 [Print] Mexico
• PMID: 11933695 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Angioplasty, Balloon
• Aortic Coarctation (therapy)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Infant, Newborn
• Male
• Mexico
• Middle Aged