Functional health status late after surgical correction of aortic coarctation

To investigate functional health status among adults previously operated for aortic coarctation (CoA) compared with healthy subjects; to assess the influence of medication and exercise capacity on patients' functional health.

Questionnaire-based investigation among 119 patients who underwent surgical repair of CoA during 1965-1985 and 36 age- and gender-matched healthy subjects using the SF-36 health survey. Original scores were transformed into norm-based scores, and summary scale scores were calculated. Exercise capacity was measured by symptom-limited bicycle ergometer testing.

Tertiary referral center.

Among 156 current survivors, 119 (74 males) participated in the study. Median age (range) at repair was 11 (0.1-40) years and 44 (26-72) years at follow-up.

Comparison of all components of SF-36 survey between patients and controls, as well as within patients regarding use of cardiovascular medication and exercise capacity.

Norm-based physical functioning scores were significantly lower among patients compared with controls (51.8 ± 7.1 vs. 54.3 ± 4.7, P < 0.05). Patients using antihypertensive medication scored significantly lower in all physical categories (physical component summary= 48.9 ± 10.4 vs. 54.9 ± 4.9, P < 0.05) as well as in vitality (46.4 ± 10.5 vs. 51.4 ± 10.4, P < 0.05). Patients with reduced exercise capacity scored significantly lower in several mental and physical categories compared with patients with normal exercise capacity (physical component summary= 49.7 ± 10.7 vs. 54.0 ± 6.2, P < 0.05; mental component summary= 44.9 ± 14.6 vs. 50.1 ± 10.0, P < 0.05).

Functional health status in patients late after CoA repair is only slightly impaired when compared with controls. However, the subgroup with reduced exercise capacity and need for cardiovascular medications have significant impairment on both physical and mental aspects of functional health.