title: Late complication after repair of aortic coarctation.
abstract: BACKGROUND
  Coarctation of the aorta is a congenital malformation that has long been considered completely correctable with appropriate surgery in childhood. However, with the aging of these patients, many late complications have been reported, and this notion must be reevaluated.
  
  
  METHODS
  We retrospectively reviewed all patients who underwent reoperation between 1992 and 2012 in our adult cardiac surgery department following surgical correction of coarctation in childhood; 18 patients over 15-years old were included in the study.
  
  
  RESULTS
  The median time from coarctation repair to reoperation was 25 years. Patients were reoperated on for several late complications: aortic valve disease secondary to bicuspid aortic valve, ascending aortic aneurysm, recoarctation, aortic arch hypoplasia, pseudoaneurysm, associated recoarctation and pseudoaneurysm, subvalvular aortic obstruction, and descending thoracic aortic aneurysm. One patient died due to an intraoperative complication. In the other cases, the surgical results were satisfactory at the 6-month follow-up. According to literature data, age at coarctation repair and surgical technique appear to be essential factors in late complications: older age and surgical repair with prosthesis interposition are associated with a higher rate of reintervention.
  
  
  CONCLUSIONS
  Patients who have undergone repair of aortic coarctation frequently remain asymptomatic for a long time. Late complications can be appropriately treated when diagnosed early. Consequently, all coarctation patients need careful lifelong follow-up, especially those with congenital aortic valve disease or surgery in childhood with interposition of prosthetic material.
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France ana.lemaire@yahoo.fr.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Lemaire
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cuttone
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Desgué
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Calin
authors.initials: C
authors.lastname: Ivascau
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Sabino
authors.initials: S
authors.lastname: Caprio
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Saplacan
authors.affiliation: Department of Cardiology, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Annette
authors.initials: A
authors.lastname: Belin
authors.affiliation: Department of Cardiac Surgery, University of Caen Basse-Normandie and University Hospital of Caen, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Babatasi
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D001017:Aortic Coarctation / Q000601:surgery*; D001021:Aortic Valve; D000082882:Bicuspid Aortic Valve Disease; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006349:Heart Valve Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D019736:Prostheses and Implants / Q000009:adverse effects*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000379:methods
keywords: Aortic aneurysm; Aortic coarctation; Aortic valve; Blood vessel prosthesis implantation; Vascular surgical procedures