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[Aortic coarctation: different anatomo-clinical forms depending on the age of presentation]
L F Valenzuela García1, R Vázquez García, L Pastor Morales
1Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla.
Revista Espanola De Cardiologia
|August 26, 1998
Summary
Age at presentation significantly impacts coarctation of the aorta characteristics and surgical outcomes. Early diagnosis and tailored treatment are crucial for improving patient prognosis in this congenital heart defect.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Defects
Background:
- Coarctation of the aorta (CoA) is a congenital narrowing of the aorta, a critical condition requiring timely intervention.
- Understanding the variations in CoA presentation and outcomes across different age groups is essential for effective management.
- Previous studies have highlighted the importance of age in CoA, but comprehensive analysis of anatomo-clinical features and surgical results by age is needed.
Purpose of the Study:
- To analyze the anatomo-clinical characteristics of coarctation of the aorta based on age at presentation.
- To evaluate the surgical findings and outcomes of coarctation of the aorta repair across different age cohorts.
- To identify age-specific patterns in presentation, associated anomalies, and postoperative results for coarctation of the aorta.
Main Methods:
- Retrospective study of 82 consecutive patients with coarctation of the aorta, analyzing clinical, angiographic, and intraoperative data.
- Patients were stratified into three age groups: under 1 year (Group A), 1-12 years (Group B), and over 12 years (Group C).
- Surgical outcomes, including complications and mortality, were assessed for each age group.
Main Results:
- The prevalence of preductal coarctation of the aorta and associated left-to-right shunts varied significantly by age group (p=0.003 for preductal form).
- Clinical presentation differed markedly: congestive heart failure in infants (Group A), incidental findings in children (Group B), and hypertension in older patients (Group C).
- Left ventricular hypertrophy was more common in older patients (54.7% in Group C), and postoperative complication rates, including death, were highest in the youngest group (90.0% in Group A).
Conclusions:
- Age at clinical presentation is a critical determinant of anatomical variations, clinical course, and surgical outcomes in coarctation of the aorta.
- Distinct clinical manifestations and associated conditions necessitate age-specific diagnostic and therapeutic strategies for coarctation of the aorta.
- Surgical correction of coarctation of the aorta carries a higher risk of complications in infants, underscoring the need for careful perioperative management.