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Eur Heart J ; 29(16): 2042-8, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18550553

RESUMO

AIMS: To assess the efficacy, safety, and long-term results of the balloon angioplasty of recoarctation. METHODS AND RESULTS: 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. CONCLUSION: 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.


Assuntos
Angioplastia com Balão , Coartação Aórtica/terapia , Adolescente , Adulto , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/mortalidade , Coartação Aórtica/mortalidade , Criança , Pré-Escolar , Eletrocardiografia , Feminino , Humanos , Lactente , Masculino , Recidiva , Retratamento , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
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