Abstract
Background: percutaneous balloon dilation of corotation of aorta is a less invasive and alternative to surgical repair for patients with discrete coaction of aorta and although the used of balloon angioplasty in patients with recurrent postoperative coarctation gained a wide consensus, the use this technique for native coarctation is still controversial in children less one years. 
 Objective: to evaluate the immediate and late result of balloon dilation of native coarctation of aorta in infant and children.
 Type of the study: A prospective study. 
 Subjects & Methods: The study was done on forty-five patients who were referred for cardiac catheterization and balloon angioplasty of native coarctation of the aorta at Ibn-AL-Bitar center for cardiac surgery between January 2015 to May 2016.Left heart catheterization was performed with evaluation of the morphology and pressure gradient across the stenotic segment of aorta. Follow up evaluations were done between 1 week and 18 months after discharge (mean 6 months) with transthoracic echocardiography. 
 Results: The age of patients range from 1month to 4 years (median age at time of procedure was12.3month). Associated lesions in 11 patients (24.4%). Immediate results were reduction in gradient from 42.5± 17.3 to 10.3± 8.2 mm Hg in forty-two patients (93.3%). Late result during follow up period, 29 patients (69%) had maintain gradient less than 20mmHg. Complications were reported in 6 patients (13.3%). there was one procedure related death (2.2%). 
 Conclusions: Balloon angioplasty for treatment of native coarctation of the aorta is effective with sustained benefit on long-term follow-up in infants and children >6 months. Transverse arch hypoplasia and children <6 months old has major effect on late outcome of recurrent coarctation of aorta.
Highlights
Coarctation of the aorta is thought to be caused by a malformation of the aortic media that creates prominent posterior infoldings, which, in some cases, extends around the entire circumference of the aorta
The suprasternal notch views are used for Doppler interrogation, but they often do not display the anatomy of the coarctation well
A prospective study was done between January 2015 to May 2016 for 45 patients who were referred for cardiac catheterization and balloon angioplasty of native coarctation of the aorta on the recommendation of the attending pediatric cardiologist at Ibn-AL-Bitar center for cardiac surgery
Summary
Coarctation of the aorta is thought to be caused by a malformation of the aortic media that creates prominent posterior infoldings (the posterior shelf), which, in some cases, extends around the entire circumference of the aorta. The lesion is most often discrete, but it may be a long segment or tortuous in nature In infants, those with associated left ventricular outflow obstruction or a ventricular septal defect, there may be diffuse hypoplasia of the transverse aortic arch and isthmus, proximal to the discrete coarctation. There is a gradient between both the systolic and diastolic pressures on either side of the stenosis This results in a classic sawtooth pattern with the continuous flow on continuous wave Doppler interrogation. After a brief period of medical management to stabilize the child, definitive repair should be performed [1] Intervention in this age group usually involves surgical relief of the obstruction with excision of the area of coarctation and extended end-to-end repair or end-to-side anastomosis with absorbable sutures to allow remodeling of the aorta with time. This study is aimed to evaluate the immediate, late result and complications of balloon angioplasty of native coarctation of descending aorta in children with different age group
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