Aortic coarctation occurs in 5-8% of newborns with congenital heart disease. Surgical treatment is an obligatory standard of clinical management in children with primary coarctation under 6 month of age.
The aim of this study is to present our experience in interventional cardiology procedures for primary and secondary aortic coarctation.
39 pts aged from 6 days to 12 months required balloon angioplasty while in 6 pts stent implantation was done.
Primary coarctation of aorta appeared in 16 pts ( 9 newborns) aged from 6 to 75 days( mean 23).
Intervention was performed as an emergency management in pts not qualified for surgical techniques due to severe condition or additional pathology (critical aortic valve stenosis, multi-organ insufficiency, pulmonary hypertension or severe infection).
Recurrent or residual coarctation was present in 23 pts, aged from 1.5 to 12 months( mean 152 days), coexisting usually with other complex heart defects (TGA+VSD+CoA,Taussig-Bing+CoA, VSD+CoA, IAA+VSD).
In all pts interventional procedures were used efficiently. The mean pressure gradient decreased from 35.7 to 11.4 mmHg in pts with primary CoA and from 37.8 to 8.6 mmHg in pts with restenosis (evaluated by cardiac catheterization).
4 newborns with additional critical aortic valve stenosis were undergone balloon valvuloplasty simultaneously with good effectiveness.
Stent implantation was successfully done in 4 pts with primary tubular stenosis of aortic isthmus and concomitant hipoplastic aortic arch and in 2 pts due to recoarctation.
Conclusions:
Emergency interventional cardiology methods in children with primary CoA under 6 month of age are worth to consider .