Balloon Angioplasty for Recoarctation in Infants with Isolated Aortic Coarctation and Coarctation Associated with Other Congenital Heart Diseases

Background: For infants who underwent surgical coarctation repair and required balloon angioplasty for recoarctation within the first year of life, data are limited—especially regarding safety, mid-term efficacy, and reintervention risk factors. Methods: This retrospective study included the data of 33 infants who underwent surgical correction of CoA within their first three months of life and whose first cardiac catheterization for recoarctation—defined by a systolic echocardiographic gradient of ≥20 mmHg—was performed within the first year of life. Results: The median age at repair was 21 days, and that at angioplasty was 77 days. The peak systolic gradient decreased from 40.0 to 21.0 mmHg (p < 0.001), and the mean gradient decreased from 13.9 to 6.7 mmHg (p = 0.02). The aortic stenotic diameter increased from 3.2 to 4.1 mm (p < 0.001), and the z score increased from −4.2 to −2.7 (p < 0.001). Right arm systolic blood pressure dropped from 111.8 to 88.2 mmHg (p < 0.001); 7% of cases remained hypertensive. Complications occurred in 12% of patients, and reintervention was needed in 39.4%. Association with other congenital heart disease increased reintervention risk (OR 4.51). Follow-up gradients were as follows: 27.4 ± 10.2 mmHg (1 year), 24.6 ± 8.3 mmHg (2 years), 32.8 ± 18.8 mmHg (5 years), and 35.4 ± 23.2 mmHg (7 years). Conclusions: Early balloon angioplasty for postoperative recoarctation is safe, effective, and repeatable, with a high procedural success rate and sustained hemodynamic improvements. Reinterventions were more common in patients with additional CHD, though outcomes remained favorable.