58. Double coronary balloon angioplasty of the aorta in an infant

Abstract

We are reporting the first case of double coronary balloon usage in infants. A 10 weeks old male infant underwent successful surgical repair for severe coarctation of the aorta at the age of 14 days with end to end anastamosis. Later on, developed significant symptomatic recoarctation. During cardiac catheterization, the narrowed segment appeared long. He did not respond to a pliable low pressure balloon dilatation. Because of the weight of the infant (4.0 kg) and to avoid vascular injury we elected to use 2 high pressure coronary balloons through one 4F sheath. The procedure was successful with drop in pressure gradient from 30 mmHg to 3 mmHg, and significant angiographic improvement. Nine months post procedure there was no recoarctation and the infant is stable, asymptomatic and thriving well. Conclusion: high pressure coronary balloons can be used safely and effectively in small infants to avoid the use of larger introducers and hence avoid arterial vascular injury.