Percutaneous balloon coarctation angioplasty: long-term results.

One hundred and ten patients, age 2 days to 35 years (mean 7.0 +/- 7.0 years), have undergone 118 percutaneous balloon angioplasty procedures for discrete coarctation of the aorta since April 1982. The mean systolic gradient was significantly decreased from 48 +/- 22 to 8 +/- 7 mmHg after angioplasty (P less than 0.0001). Long-term results were evaluated in 95 patients, by follow-up catheterization in 30 and Doppler echocardiography in 65 patients. The follow-up period was 1-9 years (4.2 +/- 2.1). At follow-up the mean residual gradient was 9 +/- 8 mmHg. On the basis of follow-up data, four groups of patients were identified: group I consisted of 53 patients over 3 months of age with native coarctation of the aorta; group II consisted of 13 patients with postoperative coarctation restenosis; group III consisted of 21 infants 3 months of age or younger with native coarctation of the aorta; and group IV consisted of eight infants who developed postdilatation restenosis. Patients in groups I and II had good results and required no redilatation or surgical repair. In group III successful redilatation in eight and surgical repair in seven infants were performed 1 month to 5 years after the initial dilatation. There were no mortalities related to the 118 dilatation procedures. Of the seven patients who had surgical repair of the coarctation and the associated cardiac anomalies, four expired in the immediate postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)