Outcome after extended arch repair for aortic coarctation.
OBJECTIVE
To assess survival and long term arch patency rates in a consecutive group of children after extended arch repair for coarctation of the aorta.


METHODS
Review of 191 consecutive children (154 (81%) under 1 year of age) operated on between 1990 and 2002 by a single surgeon using extended arch reconstructive techniques. For assessment of survival patients were divided into three groups: 1, coarctation alone, n = 104; 2, coarctation and ventricular septal defect, n = 38; and 3, coarctation in association with complex intracardiac anomalies, n = 49. A prospective and systematic clinical and echocardiographic evaluation of the aortic arch was undertaken.


RESULTS
Median time to follow up was 4.2 years (range 1-10.6 years). Overall actuarial survival was 92%, 88%, and 88% at two, five, and 10 years. Mortality was significantly higher in those patients with complex intracardiac anatomy. Arch obstruction recurred in seven of 165 (4.2%) patients: four of 139 (2.9%) term and three of 10 (30%) premature infants (p < 0.001).


CONCLUSIONS
Survival after extended arch reconstruction for coarctation is excellent. At long follow up recurrent arch obstruction is rare, with prematurity the only risk factor.
Thomson
J D R
JD
Department of Congenital Cardiology, Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK. john.thomson@lineone.net
Mulpur
A
A
Guerrero
R
R
Nagy
Z
Z
Gibbs
J L
JL
Watterson
K G
KG
D000293:Adolescent; D001013:Aorta, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency