Korean J Thorac Cardiovasc Surg.
2007 Feb;40(2):83-89.
Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta
- Affiliations
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- 1Division of Pediatric Cardiac Surgery, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medine,University of Ulsan, Korea. dmseo@amc.seoul.kr
- 2Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medine, University of Ulsan, Korea.
- 3Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center, College of Medine, University of Ulsan, Korea.
Abstract
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BACKGROUND: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist.
MATERIAL AND METHOD: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods.
RESULT: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups.
CONCLUSION
Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.
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