doi:10.1016/j.amjcard.2009.12.023

(Am J Cardiol 2010;105:1176 –1180)

Manuscript received October 7, 2009;

Revised manuscript received and accepted December 3, 2009.

Effectiveness and Safety of Balloon Dilation of Native Aortic

Coarctation in Premature Neonates Weighing <2,500 Grams

Authors

Abraham Rothman, MD, Alvaro Galindo, MD, William N Evans, MD, Juan C Collazos, MD, Humberto Restrepo, MD, MPH

Source

Children’s Heart Center Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, NV 89109, USA. Email: rothman@childrensheartcenter.com.

Abstract

Six neonates weighing <2,500 g with native coarctation of the aorta underwent balloon dilation. Of the 6 neonates, 4 were female and 2 were male, with a mean age of 14 days

(range 9 to 20) and a mean weight of 1,900 g (range 790 to 2,500). The procedure was acutely successful in all 6 patients; the peak gradient decreased from 38 _ 19 mm Hg to

11 _ 3 mm Hg. The diameter increased from 1.5 _ 0.6 mm to 3.6 _ 0.7 mm. Of the 6 patients, 3 had required no additional intervention at a mean of 42 months after the initialdilation, and 3 had developed restenosis a mean of 2.4 months after the initial dilation and underwent successful redilation. Of the latter 3 patients, 2 developed restenosis and underwent surgical repair 37 and 68 days after the second dilation, and 1 of these patients developed recoarctation after surgery that was treated successfully with balloon dilation 54 days after the end-to-end repair. In conclusion, premature neonates weighing <2,500 g with coarctation of the aorta appear to respond acutely to balloon dilation. Some patients will have a successful long-term result after a single balloon dilation procedure. However, restenosis is common and tends to develop rapidly.

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