Late cardiovascular complications after surgical or balloon angioplasty of coarctation of aorta in an Asian cohort.
Late cardiovascular complications after intervention for coarctation of the aorta (CoA) might be common. Such data, especially in Asian populations, are still limited. A total of 169 patients with CoA who survived balloon (n = 41) or surgical (n = 128) intervention from 1986 to 2004 were enrolled. The total follow-up was 1,776 patient-years, and the patient age at last follow-up was 14.7 +/- 8.5 years. Reintervention for recoarctation, systemic hypertension, and left ventricular outflow tract obstruction (LVOTO) was subsequently noted in 57 (34%), 36 (21.3%), and 24 (14.2%) patients, respectively, without significant differences between the balloon and surgical groups. The 20-year freedom from reintervention, systemic hypertension, and LVOTO rate was 52%, 78.6%, and 80.8% in the balloon group and 59%, 51%, and 81.9% in the surgical group, respectively. The age at CoA intervention and the aortic geometry after CoA intervention of gothic type were common risk factors for reintervention for recoarctation and late systemic hypertension. In contrast, the presence of bicuspid aortic valves and gothic arch geometry after CoA intervention increased the risk of LVOTO. Plasma renin/aldosterone activities were not elevated in those with or without systemic hypertension. In conclusion, the profile of reintervention for recoarctation and late systemic hypertension after CoA interventions in our Asian cohort with CoA was similar to that observed in white patients. Asian patients might have a lower risk of LVOTO.
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University Medical College, Taipei, Taiwan.
Hsin-Hui
HH
Chiu
Shuenn-Nan
SN
Chiu
Fu-Chang
FC
Hu
Chun-An
CA
Chen
Ming-Tai
MT
Lin
Jou-Kou
JK
Wang
Chung-I
CI
Chang
Yih-Shang
YS
Chen
Ing-Sh
IS
Chiu
Mei-Hwan
MH
Wu
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D001017:Aortic Coarctation / Q000175:diagnosis / Q000628:therapy*; D044466:Asian People; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D055815:Young Adult