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The Annals of Thoracic Surgery, Vol 47, 853-856, Copyright © 1989 by The Society of Thoracic Surgeons
K Ala-Kulju and L Heikkinen
Twenty-two (32.8%) of 67 patients who had patch graft aortoplasty for
aortic coarctation underwent reoperation because of aneurysm formation
opposite or at the site of the patch. The mean age at primary repair was
25.3 years (standard deviation, 9.5 years). Reoperation took place 12.3
years (standard deviation, 3.7 years) later. In 19 patients, the aneurysm
was resected and the aorta reconstructed with a tubular prosthesis. In 3
patients, the aneurysm was given external support. There were no hospital
deaths. Recurrent nerve paralysis (36%) and bleeding necessitating repeat
thoracotomy (32%) were the most common complications. Mean follow-up was
4.6 years. No aneurysms developed at the site of reoperation. Two patients
died of causes not related to reoperation. Reconstruction with a tubular
prosthesis gives good long- term results in patients with aneurysm
formation after patch grafting for coarctation. External support offers
technical advantages in select patients. Close follow-up of patients who
have coarctation repair with a patch graft is essential.
ARTICLES
Aneurysms after patch graft aortoplasty for coarctation of the aorta: long-term results of surgical management
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
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