Twenty-two years of follow-up results of balloon angioplasty for discreet native coarctation of the aorta in adolescents and adults

Background and Aims Although the immediate and intermediate-term results of balloon angioplasty(BA) for patients with aortic coarctation (AC) have been encouraging, there is paucity of data on long-term follow-up results. This study evaluated the long-term (up to 22 years) follow-up results of BA in adolescent and adult patients with discrete (shelf-like) coarctationof the aorta. Methods Follow-up data of 58 patients (mean age 24 ± 9 years) undergoing BA for discrete AC at median interval of 13.4 years including cardiac catheterization, magnetic resonance imaging, and Doppler echocardiographyform the basis of this study. Results No early deaths occurred. Balloon angioplastyproduced immediate reduction in peak AC gradient from 60 ± 22 mm Hg to 8.5 ± 8 mm Hg ( P P = .01). Five patients (8%) with suboptimal initial outcome (peak gradient >20 mm Hg) developed restenosis, and 4 of these had successful repeat angioplasty. Aneurysm developed at the site of dilatation in 4 patients (7%). Magnetic resonance imaging follow-up results revealed no new aneurysm. In one patient, the aneurysm increased in size, but no recoarctation or appreciable changes in the Doppler gradient across the AC site was noted. The blood pressure had normalized without medical treatment in 29 (50%) of the 58 patients. Conclusion Long-term results of BA for discrete AC are excellent and should be considered as first option for treatment of this disease.