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Pediatric Cardiology

, Volume 17, Issue 3, pp 184–188 | Cite as

Magnetic resonance imaging demonstration of “Remodeling” of the aorta following balloon angioplasty of discrete native coarctation

  • H. S. Weber
  • T. Mosher
  • R. Mahraj
  • B. G. Baylen
Original Articles

Abstract

Assessment of the hemodynamic and anatomic results following balloon angioplasty of discrete native coarctation of the aorta, with particular attention to “remodeling,” has required repeat cardiac catheterization and angiography, which is invasive and has limited resolution. Eight patients with hypertension and discrete native coarctation with an otherwise normally developed aortic arch underwent angioplasty at 5.0±6.8 years of age. Angiographic cross-sectional areas of the aorta indexed to body surface area at the isthmus (I), coarctation site (C), and 1 cm distal to the coarctation site (Cd) pre- and postangioplasty were compared with MRI-indexed cross-sectional areas 18±10 months (MRI-1) and 35±11 months (MRI-2) postangioplasty. From preangioplasty to MRI-2, the isthmus was smaller (149±22 versus 127±27 mm2/m2;p<0.05). The coarctation site was larger postangioplasty (25±9 versus 116±40 mm2/m2;p<0.001) with continued growth at latest follow-up (116±40 versus 164±36 mm2/m2;p<0.01). The segment 1 cm distal to the coarctation site continued to decrease in area at latest follow-up (267±78 versus 163 ±38 mm2/m2;p<0.001). I versus C versus Cd at MRI-2 were similar, whereas postangioplasty and MRI-1 cross-sectional area measurements were significantly different. Following angioplasty of discrete native coarctation, the aorta becomes more uniform or undergoes “remodeling.” Noninvasive MRI is an effective means of evaluating the anatomic result following balloon angioplasty, obviating the need for repeated invasive cardiac catheterizations.

Key words

Aortic coarctation Balloon angioplasty Remodeling 

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References

  1. 1.
    Amparo EG, Higgins CB, Shafton EP (1984) Demonstration of coarctation of the aorta by magnetic resonance imaging.AJR Am J Roentgenol 143:1192–1194PubMedGoogle Scholar
  2. 2.
    Boxer RA, LaCorte MA, Singh S, et al (1986) Nuclear magnetic resonance imaging in evaluation and follow-up of children treated for coarctation of the aorta.J Am Coll Cardiol 7:1095–1098PubMedGoogle Scholar
  3. 3.
    Cooper RS, Ritter SB, Rothe WB, et al (1987) Angioplasty for coarctation of the aorta: long term results.Circulation 75:600–604PubMedGoogle Scholar
  4. 4.
    De Lezo JS, Sancho M, Pan M et al (1989) Angiographic followup after balloon angioplasty for coarctation of the aorta.J Am Coll Cardiol 13:689–695PubMedCrossRefGoogle Scholar
  5. 5.
    Marvin WJ, Mahoney LT, Rose EF (1986) Pathological sequelae of balloon dilation angioplasty for unoperated coarctation of the aorta in children.J Am Coll Cardiol 7:117A [abstract]Google Scholar
  6. 6.
    Morrow WR, Vick GW, Nihill MR, et al (1988) Balloon dilation of unoperated coarctation of the aorta: short and intermediate term results.J Am Coll Cardiol 11:133–138PubMedGoogle Scholar
  7. 7.
    Rao PS (1989) Balloon angioplasty of aortic coarctation: a review.Clin Cardiol 12:618–628PubMedCrossRefGoogle Scholar
  8. 8.
    Rao PS, Carey P (1989) Remodeling of the aorta after successful balloon coarctation angioplasty.J Am Coll Cardiol 14:1312–1317PubMedCrossRefGoogle Scholar
  9. 9.
    Rees S, Somerville J, Ward C, et al (1989) Coarctation of the aorta: MR imaging in late postoperative assessment.Radiology 173:499–502PubMedGoogle Scholar
  10. 10.
    Stern HC, Locher D, Wallnofer K, et al (1991) Noninvasive assessment of coarctation of the aorta: comparative measurements by two-dimensional echocardiography, magnetic resonance, and angiography.Pediatr Cardiol 12:1–5PubMedCrossRefGoogle Scholar
  11. 11.
    Tynan M, Finley JP, Fontes V, Hess J, Kan J (1990) Balloon angioplasty for the treatment of native coarctation: results of valvuloplasty and angioplasty of congenital anomalies registry.Am J Cardiol 65:790–792PubMedCrossRefGoogle Scholar
  12. 12.
    Waldman JD, Karp RB (1993) How should we treat coarctation of the aorta?Circulation 87:1043–1045PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1996

Authors and Affiliations

  • H. S. Weber
    • 1
  • T. Mosher
    • 2
  • R. Mahraj
    • 2
  • B. G. Baylen
    • 1
  1. 1.Department of Pediatrics (Cardiology)The Pennsylvania State University Childrens HospitalHersheyUSA
  2. 2.Department of RadiologyThe Pennsylvania State University Childrens HospitalHersheyUSA

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