| Long-term follow-up results of balloon angioplasty of postoperative aortic recoarctation. | |
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MedLine Citation:
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PMID: 9462608 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Immediate- and short-term follow-up results of balloon dilatation of aortic recoarctation following surgery have been well documented, but there is sparse data on long-term follow-up. During a 10-year period ending in August 1995, 33 children, aged 2 months to 14 years old, underwent balloon angioplasty of aortic recoarctation. Prior surgery included resection and end-to-end anastomosis (n = 9), subclavian flap (n = 16) or prosthetic (Dacron or Gore-Tex) patch (n = 5) angioplasty, and repair of an interrupted aortic arch (n = 3). Recoarctation developed 1 month to 14 years (mean +/- SD 29 +/- 44 months) after surgery. The indications for angioplasty were peak-to-peak systolic gradients > 20 mm Hg and systemic hypertension and/or congestive heart failure. After balloon angioplasty, the peak-to-peak systolic pressure gradient across the coarctation decreased from 48 +/- 22 to 13 +/- 15 mm Hg (p <0.01), and the size of the coarcted segment increased from 3.3 +/- 1.4 to 6.5 +/- 2.3 mm (p <0.01). Follow-up angiography and/or magnetic resonance imaging were performed in 20 children 17 +/- 12 months after angioplasty. No aneurysms were observed and improvement in the diameter of the coarcted aortic segment (9 +/- 3 mm) persisted. One- to 10-year (median 5) clinical follow-up was available in 32 children. During follow-up, 2 children required surgery to repair a long tubular isthmic narrowing. The residual gradients, determined by arm-leg systolic blood pressure difference, were 5 +/- 8 mm Hg. No patient was symptomatic and only 1 patient (3%) was hypertensive, controlled with antihypertensive medications. We conclude that balloon angioplasty of aortic recoarctation following all types of surgical repair is feasible, safe, and effective with good long-term results. We recommend balloon angioplasty as the procedure of choice in the management of postsurgical recoarctation with hypertension and/or congestive heart failure. |
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Authors:
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G Siblini; P S Rao; S Nouri; B Ferdman; S B Jureidini; A D Wilson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 81 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-02-19 Completed Date: 1998-02-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 61-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, Saint Louis University School of Medicine/Cardinal Glennon Children's Hospital, Missouri 63104-1095, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Angioplasty, Balloon / standards* Aortic Coarctation / complications, diagnosis, surgery*, therapy* Child Child, Preschool Coronary Angiography Echocardiography, Doppler Female Follow-Up Studies Heart Failure / etiology Humans Hypertension / etiology Infant Magnetic Resonance Imaging Male Patient Selection Recurrence Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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