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Journal of the Korean Pediatric Society 2001;44(12):1404-1412.
Published online December 15, 2001.
Results of Balloon Angioplasty in Patients with Coarctation of the Aorta
Hyun Kyung Roh1, Bong Hee Seo2, Jae Young Choi2, Jin Sung Ko3, Jong Kyun Lee2, Jun Hee Sul2, Sung Kyu Lee2
1Division of Pediatric Cardiology, Yonsei Cardiovascular Center and Cardiovascular Research, Institute, Yonsei University College of Medicine, Seoul, Korea
2Division of Pediatric Cardiology, Yonsei Cardiovascular Center and Cardiovascular Research, Institute, Yonsei University College of Medicine, Seoul, Korea
3Division of Pediatric Cardiology, Yonsei Cardiovascular Center and Cardiovascular Research, Institute, Yonsei University College of Medicine, Seoul, Korea
대동맥 축착 환아에서 시행한 경피적 풍선 혈관성형술의 결과
노현경1, 서봉희2, 최재영2, 고진성3, 이종균2, 설준희2, 이승규2
1연세대학교 의과대학 심장혈관병원 소아심장과
2연세대학교 의과대학 심장혈관병원 심혈관 연구소
3연세대학교 의과대학 심장혈관병원 소아심장과, 심혈관 연구소
Abstract
Purpose
: This study was undertaken to analyze and compare the effects of percutaneous balloon angioplasty(BAP) on postoperative re-coarctation and native coarctation of the aorta(CoA) and to thereby contribute to the development of treatment methods for CoA.
Methods
: The subjects in this study were 21 children who had undergone BAP from Jan. 1996 to Dec. 2000 in the Division of Yonsei Pediatric Cardiology. The relation between factors such as pressure and diameter changes across the coarctation segment together with hemodynamic and morphologic variables of children with postoperative re-coarctation and native CoA was analyzed through retrospective study of medical records.
Results
: Among the 21 cases, 11 children showed a decreased pressure gradient across the coarctation segment of less than 20 mmHg(average : 11±5 mmHg) after BAP was performed. In postoperative re-coarctation, the pressure gradient across the coarctation segment significantly fell from 56±21(30-90) mmHg to 20±13(0-50) mmHg(P<0.001) after BAP, while in native CoA, the pressure gradient decreased from 57±13(40-70) mmHg to 22±14(10-40) mmHg(P<0.001) after BAP. The diameter of the narrowest coarctation segment was significantly increased in native CoA and postoperative re-coarctation after BAP. The factor that most affected our results was the ratio of isthmic/descending aortic dimension showing an inverse relationship between the ratio of isthmic/descending aortic dimension and pressure gradient after BAP(γ=-0.473, P=0.030). Complications included one case of femoral artery stenosis, one case of femoral artery interruption, and one case in which seizure occurred two days after BAP due to cerebral thrombosis.
Conclusion
: We conclude that BAP is an effective treatment modality in postoperative recoarctation and native CoA.
Key Words: Coarctation of the aorta, Balloon angioplasty, Isthmus


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