When is balloon angioplasty indicated in the treatment of coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Despite these problems, surgical repair is considered by many to be the therapeutic option of choice in the treatment of aortic coarctation. Some groups of workers, including the authors' group, consider balloon angioplasty the initial therapy of choice and reserve surgical intervention for the following coarctations:

  • Coarctations that involve the long segment of the aorta

  • Coarctations that are completely or almost completely occluded so that no catheter or guide wire can be passed across the coarcted segment

  • Coarctations that are associated with a large patent ductus arteriosus and ventricular septal defect that requires prompt surgical intervention for the primary cardiac problem.

Balloon angioplasty

Gruntzig's technique of balloon angioplasty was adopted by Sos et al (1979), Singer et al (1982), and Sperling et al (1983) for enlargement of coarcted aortic segments in a postmortem specimen, postsurgical recoarctation, and native coarctation, respectively. Other cardiologists then used this technique to treat native coarctation of the aorta. Numerous investigators reported their experiences with balloon angioplasty of native aortic coarctations. However, the use of balloon angioplasty for treatment of native aortic coarctation is controversial. [1, 58] This section describes the technique and the results of balloon angioplasty.

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