Surgical repair was considered the conventional treatment for native aortic coarctation while balloon angioplasty emerged recently as an alternative to surgical repair and considered the treatment of choice in recurrent postoperative coarctation but its use with or without endovascular stent implantation for native coarctation remains controversial.
We sought to investigate the results of transcatheter treatment for native aortic coarctation in adults and compare the success rates and early complications rates between balloon angioplasty and self expandable stent.
Fifty one patients with native coarctation underwent transcatheter intervention in two different cardiac centers in Baghdad between January 2001 and July 2004 , 26 patients underwent balloon angioplastry alone while 25 patients had endovascular stenting for coarctation. Hemodynamic, angiographic and follow up data were reviewed and analyzed for each patient.
Tthe procedure acutely reduced the transcoarctation systolic pressure gradient from 68+/-23 to 7.5+/-11 mmHg with increase in minimal luminal diameter of coarct segment more than two folds post intervention. The immediate success rate was comparable in stent and balloon group (88% versus 84% respectively) .Nearly half of our patients became normotensive without antihypertensive medication before discharge .Minor complications found to be significantly higher among balloon group as compared to stent group 34% versus 28%.
Balloon angioplasty with or without endovascular stenting is safe and effective non-surgical approach for native aortic coarctation in adult. Larger sample size and longer follow up are needed.