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KMID : 0364020070400020083
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Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 2 p.83 ~ p.89
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Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta
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Lee Seung-Cheol
Seo Dong-Man
Yun Tae-Jin
Park Jeong-Jun
Song Meong-Gun
Kim Young-Hwee
Ko Jae-Kon
Park In-Sook
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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.
Materials & Methods: 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.
Results: 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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KEYWORD
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Congenital heart disease (CHD), Coarctation of aorta, Hypertension
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