Remodeling of the aorta after successful balloon coarctation angioplasty

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Abstract

The purpose of this study was to examine whether remodeling of the aorta takes place after successful balloon angioplasty of aortic coarctation. During the 35 month period ending in December 1987, 30 children, aged 14 days to 13 years, underwent balloon angioplasty of unoperated aortic coarctation, with a resultant reduction in mean coarctation gradient from 44 ± 20 to 10 ± 8 mm Hg (p < 0.001). On the basis of results of 6 to 30 months' follow-up catheterization data in 20 children, the patients were classified into group A (13 patients with good results; gradient ≤20 mm Hg and no recoarctation on angiography) and group B (7 patients with fair or poor results; gradient >20 mm Hg with or without recoarctation on angiography). Measurements of the aorta at five sites (the ascending aorta, isthmus, coarcted segment and descending aorta distal to the coarctation and at the level of the diaphragm) were made in two angiographic views, corrected for magnification and averaged. A standardized diameter of the aorta at the five locations was calculated for each case before angioplasty and at follow-up study, and variance of the diameter was then determined. The variance of standardized aortic measures (0.233 versus 0.287) was similar (p > 0.05) in both groups before angioplasty, whereas at follow-up study (0.057 versus 0.129) they were different (p = 0.01). There was a greater percent improvement at follow-up study (0.233 versus 0.057) in the group with good results than in the group with fair or poor results (0.287 versus 0.129). Cluster analysis was also indicative of remodeling of the aorta in the group with good results. These data indicate a greater remodeling and normalization of the aorta after successful balloon angioplasty of aortic coarctation, suggesting that normalized flow across the dilated coarctation allows optimal growth of the aortic segments. © 1989.

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Syamasundar Rao, P., & Carey, P. (1989). Remodeling of the aorta after successful balloon coarctation angioplasty. Journal of the American College of Cardiology, 14(5), 1312–1317. https://doi.org/10.1016/0735-1097(89)90434-8

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