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Late complication after repair of aortic coarctation

Anaïs Lemaire1, Fabio Cuttone2, Julien Desgué2

  • 1Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France ana.lemaire@yahoo.fr.

Asian Cardiovascular & Thoracic Annals
|November 1, 2014
PubMed

Insights

Surgical repair of coarctation of the aorta in childhood does not always prevent late complications. Lifelong follow-up is crucial for early diagnosis and treatment of these serious aortic conditions.

Area of Science:

  • Cardiovascular Surgery
  • Congenital Heart Disease
  • Adult Congenital Cardiology

Background:

  • Coarctation of the aorta (CoA) is a congenital defect historically considered fully correctable in childhood.
  • Long-term follow-up reveals significant late complications in aging patients previously treated for CoA.
  • Reevaluation of the complete curability of CoA is necessary due to emerging late morbidities.

Purpose of the Study:

  • To analyze late complications and reoperation outcomes in adult patients who underwent childhood coarctation repair.
  • To identify risk factors associated with the development of late complications after initial CoA surgery.
  • To emphasize the importance of lifelong surveillance for patients with a history of coarctation of the aorta.

Main Methods:

  • Retrospective review of adult cardiac surgery patients undergoing reoperation for CoA complications (1992-2012).
  • Inclusion criteria: 18 patients over 15 years old with prior childhood surgical correction of coarctation.
  • Data collection focused on reasons for reoperation, time from initial repair, and surgical outcomes.

Main Results:

  • Median time from initial CoA repair to reoperation was 25 years.
  • Common reoperation indications included aortic valve disease, aneurysms, and recoarctation.
  • Older age at initial repair and use of prosthetic material correlated with increased reintervention rates.

Conclusions:

  • Coarctation of the aorta repair patients often remain asymptomatic long-term but require lifelong monitoring.
  • Early diagnosis and treatment of late complications are essential for favorable outcomes.
  • Lifelong follow-up is particularly critical for patients with congenital aortic valve disease or those who had surgery involving prosthetic material.
Abstract

Keywords:
Aortic aneurysmAortic coarctationAortic valveBlood vessel prosthesis implantationVascular surgical procedures

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