Abstract
Objective
Long-term sequelae and events after coarctation repair are well described. However,
the predictive value of variables from clinical follow-up investigation for late events
and survival has rarely been investigated.
Methods
All patients who participated in the prospective cross-sectional COALA Study in 2000
with a structural clinical investigation including blood pressure measurement and
symptom-limited exercise test were contacted for reevaluation of survival, current
clinical status and major cardiovascular events.
Results
Of 273 eligible patients, 209 were available for follow-up. Nine patients had died
at a median age of 46 years (range 30–64 years), five of them due to cardiovascular complications. Late mortality after surgical
intervention was 5.7% with a median age of 41 years (range 16–64 years). Twenty-five patients had a major cardiovascular event: 12 had procedures at
the aortic valve or aortic arch, 8 had procedures for restenosis, 2 had endocarditis,
2 had a cerebrovascular insult and 1 an aortic dissection. The presence of bicuspid
aortic valve (p = 0.009), brachial-ankle blood pressure gradient >20 mmHg (p < 0.001) and reduced left ventricular function (p = 0.002) correlated with major cardiovascular events.
Conclusion
Surgical correction of coarctation of the aorta shows fairly low mortality in the
long-term follow-up. Late morbidities include recoarctation, but also the consequences
of the hemodynamics produced by a congenital bicuspid aortic valve, presence of which
is predictive for aortic valve procedures: however the predictive value of clinical
variables is limited.
Keywords
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Article info
Publication history
Published online: November 09, 2016
Accepted:
November 6,
2016
Received:
September 3,
2016
Identification
Copyright
© 2016 Published by Elsevier Ireland Ltd.
