When is balloon angioplasty the treatment of choice for coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Based on an extensive review of the literature and personal experience with the procedure for more than 25 years, some generalizations with regard to balloon therapy may be made, as follows.

Children older than 1 year and adults with discrete native coarctation are candidates for balloon dilatation. Most cardiologists agree on this issue. Long-segment coarctations or those associated with significant isthmic hypoplasia may be candidates for stent placement, especially in adolescents and adults.

Recurrent coarctation following previous balloon angioplasty may be treated with repeat balloon angioplasty; others prefer surgery. If the recoarcted segment is long, surgical treatment in younger children and stents in adolescents and adults seem appropriate.

Treatment of coarctation in neonates and infants is perhaps the most controversial issue. Many cardiologists prefer surgical intervention, whereas a few cardiologists may opt for balloon angioplasty.

Balloon angioplasty is useful in the treatment of extremely ill neonates and infants with severe coarctation; in this subset of patients, the balloon angioplasty has a significant advantage over a surgical approach.

Most cardiologists and surgeons agree that balloon angioplasty is the treatment of choice for postsurgical recoarctations.


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