| P303 | Balloon Angioplasty of Coarctation in Adults: Early, Midterm and Long-term Results. |
| H.Sievert, D.Schwemer, B.Mohajer | |
| Cardiovascular Center, Frankfurt. | |
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Background Over the last two decades balloon angioplasty with or without stent implantation has been used for both native and recurrent coarctation. Early and midterm results are promising. However, information about long-term results is very limited. Especially the risk for aneurysm formation and late restenosis are considered to be limiting factors of balloon angioplasty. We are reporting follow-up results up to 17 years. Methods Since 1985 45 patients (33 male, 12 female) underwent 50 balloon angioplasty procedures. The age ranged between 5 and 55 years, median 25 years. 10/45 patients had prior surgery. In 37 patients only balloon angioplasty was performed, in 8 patients a stent was implanted. Control angiography was performed after 6-12 months. Thereafter, a CT or MRI scan was performed every 2 to 4 years. Results 43 procedures were technically successful (residual gradient < 50 mmHg). In 41 procedures the residual gradient was < 30 mmHg. Acute complications: In five patients a dissection occurred without need for further treatment. In one patient the balloon ruptured. One patient suffered from pleural effusion and another one from a TIA with complete recovery. During follow-up (up to 17 years, mean 7±6.7 years, median 3.4 years) the following complications occurred: Aneurysm in two patients (surgery uneventful in one) and surgery for a residual stenosis in one (16 years after angioplasty). The following table shows the change in systolic and diastolic blood pressure, systolic pressure gradient and diameter of stenosis during follow-up.
Conclusions Thus, balloon angioplasty of coarctation in adults is safe. It effectively and permanently reduces both gradient and blood pressure. Late complications are rare. |