Long-term follow-up of patients after coarctation of the aorta repair☆
Section snippets
Methods
Two hundred seventy-four patients had operative repair of simple coarctation of the aorta at the University of Minnesota between 1948 and 1976. Simple coarctation is defined as an isolated coarctation of the aorta with or without a patent ductus arteriosus or a bicuspid aortic valve and without other cardiac malformations. Twenty patients (7%) died during the immediate postoperative period. Two of the 254 survivors (0.8%) were lost to follow-up. A retrospective analysis including survival
Results
Mean age at follow-up of the 252 long-term survivors (groups I, II, and III) was 40.1 ± 10.3 years (median 38.8, range 23.7 to 62.8). Mean age at diagnosis was 7.8 ± 9.3 years (median 5, range 0 to 41). Mean age at time of operation was 10.3 ± 9.5 years (median 7.3, range 0 to 41.5). Forty-seven patients (23%) were <1 year old at the initial operation, and 31 patients (11%) were >20 years old.
Operative correction was performed by resection and end-to-end anastomosis in 92% of the patients.
Discussion
Several long-term studies following coarctation repair2, 3, 4, 5, 6, 7, 8 have helped identify the most common late cardiovascular complications, but these studies have underestimated the prevalence of silent cardiovascular lesions or concomitant cardiac abnormalities. In addition to evaluating retrospective and questionnaire data, we also evaluated a group of 92 subjects who had undergone coarctation repair >20 years previously.
An undiagnosed cardiovascular abnormality was identified in 35 of
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This study was supported by the Viking’s Children Fund and Grant MO1-RR-00400 from the National Center for Research Resources, Minneapolis, Minnesota.