Abstract
Introduction. Coarctation of the aorta – a defect of critical neonatal period in the treatment of which are well established and surgical
and endovascular methods. Despite the fact that the method of balloon angioplasty of coarctation of the aorta is used from the end
of the 20th century, there are still conflicting evidence about its use in neonates.
Material and methods. the article presents the experience of balloon angioplasty of coarctation of aorta in newborns and children first
year of life (n=48). Depending on the type of stenosis patients were divided into two groups: group 1 – patients with hypoplastic form
(n=10) and group 2 – membranous form (n=38).
Results. According to angiocardiography gradient of systolic pressure on the narrowing in patients of group 1 amounted to 32.0
(14.0; 36.5) mm Hg (ranged from 3 to 60 mm Hg), the diameter of the aortic isthmus was 4.6 (3.3; 5.0) mm (from 2.8 mm to
6.0 mm), and in patients of group 2 – a gradient of systolic pressure amounted to 40.0 (30.0; 55.0) mm Hg, (ranged from 10 to
94 mm Hg), and the diameter of the isthmus making 3.0 (2.5; 3.9) mm (from 1.5 mm to 6 mm), p=0.01. Hospital mortality was
12.5% (6 patients): intraoperative mortality was 2.1% (1 case), due to the perforation of the wall of the left atrium with the development
of tamponade when performing one-stage follow-up procedure, Rashkind procedure; the mortality in the immediate postoperative
period is 10.4% (5 patients), due to the initial severity of the patients. Non-fatal complications – thrombosis of the common
femoral artery in 3 (6.3%) patients, requiring thrombectomy. In patients of group 1 the diameter of the aortic isthmus increased on
average 1.1 times (4.6 (3.3; 5.5) 5,2 mm vs (4.0; 6.5) mm, p=0.01), and systolic pressure gradient decreased 5.3 times (32.0 (14.0;
36.5) mm Hg vs 6.0 (1.5; 15.0) mm Hg, p=0.01). Among patients of group 2, the diameter of the aortic isthmus increased on average
1.7 times (3.0 (2.5; 3.9) vs 5,1 mm (4.3; 6.4) mm, p=0.01), and the gradient of the systolic pressure decreased by 10 (40.0
(30.0; 55.0) mm Hg vs 4.0 (1.0; 12.5) mm Hg, p=0.01).
Conclusion. The obtained results showed the feasibility and efficacy of balloon angioplasty in the treatment of patients with coarctation
of the aorta. Decrease of systolic pressure gradient on the isthmus, as well as increasing its diameter to allow both groups to consider
balloon angioplasty as a method of choice to stabilize the clinical condition of patients with complex congenital heart disease.
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