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Outcomes of surgery for coarctation of the aorta based on a new classification system

Kwang Ho Choi1, Hyungtae Kim1, Si Chan Sung1

  • 1Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Yangsan, Republic of Korea.

Cardiology in the Young
|May 1, 2023
PubMed

Insights

Surgical treatment for coarctation of the aorta is safe and effective, with low early and late risks. A new classification system aids in evaluating outcomes for aortic coarctation repair.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Coarctation of the aorta is a congenital heart defect requiring surgical intervention.
  • Existing classification systems may not fully capture the nuances of aortic coarctation.
  • A novel classification system was developed to categorize coarctation of the aorta based on anatomical features.

Purpose of the Study:

  • To evaluate the early and long-term surgical outcomes of coarctation of the aorta.
  • To assess the utility of a new classification system in predicting surgical results.
  • To determine the safety and efficacy of surgical repair for coarctation of the aorta.

Main Methods:

  • Retrospective review of 111 patients undergoing surgery for coarctation of the aorta (March 2011 - August 2020).
  • Classification of coarctation into Type I, II, and III, with subtypes 'a' (short isthmus) and 'b' (long isthmus).
  • Analysis of surgical techniques, early mortality, postoperative complications, late deaths, and reinterventions.

Main Results:

  • The study included 111 patients with a median age of 8 days. Various surgical techniques were employed, including extended end-to-end anastomosis (n=54).
  • Early mortality was 0.9%, with 10.8% experiencing postoperative complications. Late deaths occurred in 1.8% of patients.
  • Five patients required balloon dilatation and three underwent reoperation for restenosis. Type Ia coarctation (n=21) was treated with extended end-to-end anastomosis.

Conclusions:

  • Surgical treatment for coarctation of the aorta, guided by the new classification system, demonstrates favorable early and long-term outcomes.
  • The proposed classification system appears safe and effective for stratifying patients and evaluating surgical results.
  • This approach offers a low-risk profile for managing coarctation of the aorta.
Abstract

Keywords:
CHDCoarctation of the aortaanatomical classification

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