Key result
Primary balloon angioplasty in infants with native coarctation of the aorta significantly reduced the peak gradient from 46.3 mm Hg to 10.47 mm Hg, with a 20.45% reintervention rate.
Why the study?
Is primary balloon angioplasty safe and effective in infants with native coarctation of the aorta?
Observational (n=44)
No
Is primary balloon angioplasty safe and effective in infants with native coarctation of the aorta?
Absolute Event Rate: 10.47% vs 46.3%
p-value: p=<0.001
Primary balloon dilatation for native coarctation of the aorta in infants is a feasible and safe alternative to surgery, significantly reducing pressure gradients with an acceptable 20.45% reintervention rate.
Supports feasibility of primary balloon angioplasty in infants with native coarctation; hypothesis-generating pending randomized trials versus surgery.
Background: Balloon dilatation with or without placement of stent in native coarctation offers a good alternative to surgery. Aim: To determine feasibility and safety of primary balloon angioplasty in infants with coarctation of aorta. Materials and Methods: This was a retrospective, observational study of 44 consecutive infants undergoing balloon dilatation of native coarctation of aorta during a 4 year period from July 2009 to July 2013. Demographic details, previous history and data of chest X-ray, electrocardiogram and sequential echocardiography were collected for all the patients. The patients were followed up at 1 months, 6 months and 1 year thereafter. Results: The reintervention rate was 20.45% after successful procedure. Two patients having hypoplastic arch had successful procedure with 1 requiring reintervention. Left ventricular dysfunction was observed in 15 patients, out of them 11 patients improved immediately after the procedure. Thirty five (79.55%) patients did not undergo reintervention in whom mean gradient was reduced from 48.05±15.26 mm Hg to 10.97±5.8 mm Hg after percutaneous reintervention (p<0.0001). Also, mean diameter in this group was improved (1.94±0.52 vs 6.07±1.84 mm; p <0.0001). Early age of presentation was identified as a contributor of reintervention in the study population (p=0.009). Conclusions: This study results show that BDC in infants is a safe and feasible technique that could be effectively used as an option of surgery in order to reduce mortality and morbidity.
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Oswal et al. (2017) conducted an observational in Native coarctation of aorta (n=44). Balloon dilatation was evaluated on Peak gradient across coarctation segment (mm Hg) (p=<0.001). Primary balloon angioplasty in infants with native coarctation of the aorta significantly reduced the peak gradient from 46.3 mm Hg to 10.47 mm Hg, with a 20.45% reintervention rate.
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