Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era

• Published in: Journal of the American College of Cardiology 2005-06, Vol.45 (11), p.1844-1848
• Main Authors: Zeltser, Ilana, Menteer, Jondavid, Gaynor, J. William, Spray, Thomas L., Clark, Bernard J., Kreutzer, Jacqueline, Rome, Jonathan J.
• Format: Article
• Language: English
• Subjects: Angioplasty; Angioplasty, Balloon, Coronary; Aortic Coarctation - etiology; Aortic Coarctation - mortality; Aortic Coarctation - therapy; Biological and medical sciences; Cardiac Surgical Procedures - adverse effects; Cardiology; Cardiology. Vascular system; Catheters; Child, Preschool; Hospitals; Humans; Hypoplastic Left Heart Syndrome - surgery; Infant; Intubation; Medical sciences; Mortality; Postoperative period; Recurrence; Risk factors; Studies; Success; Survival Analysis
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2005.01.056

The objective of this study was to determine the efficacy of balloon angioplasty (BA) by comparing the immediate and long-term outcomes of patients with and without re-coarctation after a Norwood procedure. Although BA has become the standard means for treating recurrent coarctation following a Norwood operation, it has been suggested that re-coarctation remains a significant cause of morbidity and mortality. Patients who survived a Norwood operation from December 1986 through June 2001 were studied. Differences between groups were evaluated by ttest and logistic regression. Survival differences were tested by log-rank tests using Kaplan-Meier survival curves. Fifty-eight of 633 patients underwent treatment for re-coarctation (9.2%). Thirty-five patients underwent BA (before 1988, 23 had surgery). Median age at catheterization was 6.6 months (1.9 to 35.6 months). Balloon angioplasty was successful (gradient