Balloon dilatation of excised aortic coarctations

Seven children 1-6 years of age underwent aortic resection and re-anastomosis for coarctation of the thoracic aorta. The excised segments were 1-2 cm long and were dilated in vitro with a Gruntzig balloon catheter less than two hours after resection. A pressure of 4-8 atmospheres was used, and the inflated diameter of the balloon was twice the luminal diameter of the undilated coarctation. The diameter of each specimen was increased by an average of 85%, largely because of an increase in the external diameter of the coarctation. However, extremely high pressures were required for successful dilatation, producing transmedial tears in the 'normal' aorta distal to the coarctation in three specimens. These results indicate that although balloon dilatation appears feasible as palliation for aortic coarctation, further studies of its safety are necessary before instituting clinical trials.