Pediatrics & Neonatology
Volume 50, Issue 4 , Pages 152-157, August 2009

Balloon Angioplasty for Native Coarctation of the Aorta in Neonates and Infants With Congestive Heart Failure

  • Chi-Di Liang

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Taiwan
    • Corresponding Author InformationCorresponding author. Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung County 833, Taiwan
    • ,
  • Wen-Jen Su

      Affiliations

    • Department of Pediatrics, Chang Gung Children Hospital, Taoyuan, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Hung-Tao Chung

      Affiliations

    • Department of Pediatrics, Chang Gung Children Hospital, Taoyuan, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Mao-Sheng Hwang

      Affiliations

    • Department of Pediatrics, Chang Gung Children Hospital, Taoyuan, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Chien-Fu Huang

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Ying-Jui Lin

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Shao-Ju Chien

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • I-Chun Lin

      Affiliations

    • Section of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Taiwan
    • ,
  • Sheung Fat Ko

      Affiliations

    • Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan and Chang Gung University College of Medicine, Kaohsiung, Taiwan

Received 21 August 2008; received in revised form 4 December 2008; accepted 22 December 2008.

Background

Balloon angioplasty (BA) is an alternative to surgical repair for coarctation of the aorta (CoA) in children. However, its role in the treatment of native CoA in neonates and infants remains controversial. The purpose of this study was to report the midterm outcomes of BA for native CoA in neonates and infants with congestive heart failure (CHF).

Methods

Between July 2000 and March 2007, 18 neonates and infants with native CoA and CHF who underwent BA were enrolled. Patients without recoarctation were designated as group A, while those with recoarctation or CHF were designated as group B. The clinical presentations, laboratory data, and outcomes were compared between groups.

Results

There were 10 patients in group A and eight in group B. The mean age was 2.8 ± 3.1 months (range, 0.7–11 months). Mean body weight was 4.0 ± 1.9 kg (range, 2.1–8.0 kg). CHF improved markedly in all patients immediately after BA, with a reduction in systolic pressure gradient from 36.4 ± 12.0 to 5.6 ± 6.0 mmHg (p < 0.001). The recoarctation rate was 44% (8/18). The risk factors for restenosis were post-BA systolic pressure gradient > 10 mmHg (p = 0.007) and CoA diameter < 3 mm (p = 0.013).

Conclusions

The outcomes of BA for native CoA in neonates and infants with CHF remain poor. The incidence of recoarctation is high in neonates and patients whose post-BA systolic pressure gradient is > 10 mmHg or whose CoA diameter is < 3 mm.

Key Words:  balloon angioplasty , coarctation of the aorta , congestive heart failure , infant , neonate

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PII: S1875-9572(09)60054-1

doi:10.1016/S1875-9572(09)60054-1

Pediatrics & Neonatology
Volume 50, Issue 4 , Pages 152-157, August 2009

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