Coarctation and Its Surgical Repair: Mid to Long Term Follow Up in Children and Adults
Journal Title: Journal of Cardiovascular Medicine and Surgery - Year 2017, Vol 3, Issue 2
Abstract
Introduction: Coarctation of the aorta is a common defect that accounts for 58% of all congenital heart defects. Various surgical techniques are described in the literature. We hereby present our experience about surgical management of CoA and their long term outcome. Materials and Methods: This is a retrospective analysis of 70 patients operated for the aortic coarctation. Their age ranged from 641 years with mean age of 19.4 years. Demographic and clinical data was recorded for all the cases. All cases underwent surgical repair by various techniques like, Patch aortoplasty, Resection with end to end anastomosis and resection with interposition grafting. All patients were followed up for a period spanning from 4 to 12 years. Results: There were two early mortalities. Most common complication was recurrent laryngeal nerve injury and postoperative bleeding. Mean follow up was 7.8 years. 84.3% came for follow up. There was no late mortality. Thirty (43%) patients continued to be hypertensive. There was no recurrence in Coarctation. One patient who was operated with Dacron patch aortoplasty developed an aneurysm at the repair site. Conclusion: Asymptomatic patients with uncontrolled or refractory hypertension is the presenting symptoms of Coarctation. End to end anastomosis after complete excision of the coarcted segment in younger patients is the best approach and for older patients resection with interposition grafting is the preferred choice. Persistent postoperative hypertension is a concern and needs further analysis and evaluation. Postoperative CT /MRI is helpful in diagnosing complications of repair.
Authors and Affiliations
Sudhir Adalti
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