Transcutaneous angioplasty of experimental aortic coarctation

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

Research output: Contribution to journalArticlepeer-review

134 Scopus citations

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
JournalUnknown Journal
Volume66
Issue number6 I
DOIs
StatePublished - Jan 1 1982

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Transcutaneous angioplasty of experimental aortic coarctation'. Together they form a unique fingerprint.

Cite this