In four young infants with symptomatic coarctation of the aorta the narrow aortic segment was dilated with a balloon angioplasty catheter. Three of the infants also had appreciable heart defects and one infant had undergone surgery before and had had one previous dilatation. Dilatation was well tolerated and good femoral pulses appeared in all cases, but these disappeared over one to seven days. Despite this, two patients showed some symptomatic improvement over four months. One patient died after perforation of the aorta by an angiographic catheter after dilatation. Relieving coarctation in young infants by catheter dilatation appears incomplete, but it may give symptomatic improvement. Further trial of the procedure will determine whether patients who have undergone surgery and those who have not may benefit. Careful attention to technique and avoidance of manipulations after dilatation are essential if complications are to be avoided.
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