Transcutaneous angioplasty of experimental aortic coarctation

J. E. Lock, T. Niemi, B. A. Burke, S. Einzig, W. R. Castaneda-Zuniga

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

A dilatable form of juxtaductal aortic coarctation was surgically created in 29 newborn lambs. Of the 17 long-term survivors, four lambs served as controls and 13 underwent transcutaneous balloon dilation angioplasty with either polyvinylchloride or polyethylene catheters after 7-10 weeks of recovery. During growth before dilation, there was little change in the systolic gradient across the coarctation (36.6-35.3 mm Hg) despite an increase in animal weight from 3.8 to 19.3 kg. This systolic gradient remained constant in undilated lambs throughout a 6-month follow-up. Dilation produced an immediate 65% increase in the diameter of the coarctation and 68% decrease in the systolic gradient across the coarctation site. Successful dilation required very high (6-8 atmospheres) dilating pressures. This gradient relief persisted throughout a follow-up of up to 1 year. Although no late sequelae could be attributed to the angioplasty, one lamb suffered an anterior aortic tear (associated with a difficult postdilation wire passage across the dilation site), which resulted in fatal intrathoracic hemorrhage. Gross pathologic inspection demonstrated intimal and medial tears in successfully dilated lambs in the first 3 days after dilation; on late pathologic examination, the intima appeared completely healed, without evidence of aneurysms or accelerated atheroma formation, within 2 months. These results, in conjunction with previous human in vitro studies, support the hypothesis that human aortic coarctation may be a dilatable lesion, although the safe limits and optimal protocols for dilating human coarctations are not known.

Original languageEnglish (US)
Pages (from-to)1280-1286
Number of pages7
JournalCirculation
Volume66
Issue number6 I
StatePublished - 1982
Externally publishedYes

Fingerprint

Aortic Coarctation
Angioplasty
Dilatation
Tears
Tunica Intima
Balloon Angioplasty
Polyethylene
Atherosclerotic Plaques
Atmosphere
Aneurysm
Survivors
Catheters
Newborn Infant
Hemorrhage
Pressure
Weights and Measures
Growth

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Lock, J. E., Niemi, T., Burke, B. A., Einzig, S., & Castaneda-Zuniga, W. R. (1982). Transcutaneous angioplasty of experimental aortic coarctation. Circulation, 66(6 I), 1280-1286.

Transcutaneous angioplasty of experimental aortic coarctation. / Lock, J. E.; Niemi, T.; Burke, B. A.; Einzig, S.; Castaneda-Zuniga, W. R.

In: Circulation, Vol. 66, No. 6 I, 1982, p. 1280-1286.

Research output: Contribution to journalArticle

Lock, JE, Niemi, T, Burke, BA, Einzig, S & Castaneda-Zuniga, WR 1982, 'Transcutaneous angioplasty of experimental aortic coarctation', Circulation, vol. 66, no. 6 I, pp. 1280-1286.
Lock JE, Niemi T, Burke BA, Einzig S, Castaneda-Zuniga WR. Transcutaneous angioplasty of experimental aortic coarctation. Circulation. 1982;66(6 I):1280-1286.
Lock, J. E. ; Niemi, T. ; Burke, B. A. ; Einzig, S. ; Castaneda-Zuniga, W. R. / Transcutaneous angioplasty of experimental aortic coarctation. In: Circulation. 1982 ; Vol. 66, No. 6 I. pp. 1280-1286.
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