Long-term (up to 20 years) results of percutaneous balloon angioplasty of recurrent aortic coarctation without use of stents
Abstrakt
To assess the efficacy, safety, and long-term results of the balloon angioplasty of recoarctation. The angioplasty was performed in 99 consecutive patients aged 36 days to 32.6 years (median 268 days).
Recoarctation to descending aorta diameter ratio increased from 0.44 (0.35/0.50) to 0.66 (0.57/0.77), P < 0.001. Systolic gradient was reduced from 34.0 (26.0/44.75) to 15.0 (8.25/27.0) mmHg, P < 0.001.
In seven patients (7.1%) the procedure was ineffective. One patient (1%) with heart failure died within 24 h after a successful angioplasty and in another (1%) an intimal abruption necessitated surgical revision.
The follow-up ranged up to 20.7 years (median 8.1 years). Actuarial probability of survival 20.7 years after the procedure was 0.91, and of reintervention-free survival was 0.44.
Older age at the angioplasty was associated with a higher incidence of reinterventions (hazard ratio 1.057; 95% confidence interval 1.012-1.103; P = 0.010). The type of surgery and the recoarctation anatomy did not influence the outcome.
In 69 patients aneurysm formation was studied by high-sensitive methods with only one positive finding per 462 patient-years. Angioplasty is safe and effective regardless of the type of surgery used and the recoarctation anatomy.
Older age at the angioplasty is associated with a higher incidence of reinterventions.