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Ann Thorac Surg 2001;72:2060-2064
© 2001 The Society of Thoracic Surgeons

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Original article: cardiovascular

Benefits of surgical repair of coarctation of the aorta in patients older than 50 years

^a Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
^b Department of Congenital Heart Diseases, Deutsches Herzzentrum Berlin, Berlin, Germany

Accepted for publication July 16, 2001.

* Address reprint requests to Dr Matthias Bauer, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
e-mail: mbauer{at}dhzb.de

Background. Most patients with unrepaired coarctation of the aorta die before the age of 50 years. In patients who present at an older age, the indications for surgical treatment are controversial because the benefits of operating are unclear.

Methods. At follow-up investigation from 0.5 to 11.5 years (mean, 4 years) after primary surgical correction of coarctation in 15 patients aged 50 to 63 years (mean, 54 years), we analyzed the preoperative and postoperative complications, symptoms, need for antihypertensive drugs, and blood pressure at rest and during exercise.

Results. Preoperatively no patient had normal blood pressure at rest despite combined antihypertensive medication. There was no significant mortality or morbidity after repair. At follow-up examination only 3 patients had at rest mild hypertension, the other 12 patients were normotensive. Of the 11 tested patients, 8 displayed systolic arterial hypertension during exercise.

Conclusions. Surgical correction of coarctation can be performed after the age of 50 years with low surgical risk. Operation reduces systolic hypertension at rest and permits more effective medical treatment. Despite persistence of the hypertension during exercise, symptomatic improvement occurs in most patients.

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