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Right arrow Congenital - acyanotic

Ann Thorac Surg 2005;79:1950-1956
© 2005 The Society of Thoracic Surgeons

Original article: Cardiovascular

Long-Term Results of Surgical Coarctectomy in the Adolescent and Young Adult With 18-Year Follow-Up

John Alfred Carr, MD*, Joseph J. Amato, MD, Robert S.D. Higgins, MD

Department of Cardiothoracic Surgery, Rush University Medical Center, Chicago, Illinois

Accepted for publication January 3, 2005.

* Address reprint requests to Dr Carr, Department of Cardiothoracic Surgery, E-500, University of Chicago Medical Center, 5841 South Maryland Ave, Chicago, IL60637 (E-mail: heartandbones{at}yahoo.com).

Presented at the Fifty-first Annual Meeting of the Southern Thoracic Surgical Association, Cancún, Mexico, Nov 2–4, 2004.

BACKGROUND: There is no consensus in the literature regarding the optimal method for repair of coarctation of the aorta in the adolescent and young adult.

METHODS: We retrospectively reviewed operations in 45 patients treated between 1978 and 2003.

RESULTS: From 1978 to 2001, there were 45 adolescents or adults between the ages of 11 and 53 years (mean 21, SD ± 10) who underwent surgical correction. The perioperative mortality rate was 0% and the morbidity rate was 18%. All patients had improved blood pressure before discharge after a mean of 7 days, which ranged from 160/90 mm Hg to 90/50 mm Hg (mean 128/73 mm Hg, SD ± 17/12 mm Hg). This was an average improvement of 35 mm Hg (SD ± 26) compared with the preoperative pressure (p < 0.0005). Long-term results (defined as 5 years or more) were documented for 30 (71%) with a mean follow-up of 18.2 years (range, 67 to 293 months; SD ± 70 months). At the time of last follow-up, the blood pressure was documented and averaged 122/73 mm Hg (SD ± 11/10 mm Hg), which was a decrease of 36 mm Hg (SD ± 29) compared with the preoperative pressure (p < 0.0005). Seventy-six percent of patients were on no medications for hypertension. None of the 30 patients available for long-term follow-up has required a second operation for recurrence.

CONCLUSIONS: Surgical repair of coarctation in the adolescent and adult is safe and durable, with a high success rate in curing patients of hypertension and making them medication-free for life. The recurrence rate is low, and most patients will not require any further intervention.




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 J Am Coll CardiolHome page
J. A. Carr
The Results of Catheter-Based Therapy Compared With Surgical Repair of Adult Aortic Coarctation
J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1101 - 1107.
[Abstract] [Full Text] [PDF]


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