title: Survival and cardiovascular events after coarctation-repair in long-term follow-up (COAFU): Predictive value of clinical variables.
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 46years (range 30-64years), five of them due to cardiovascular complications. Late mortality after surgical intervention was 5.7% with a median age of 41years (range 16-64years). 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 >20mmHg (p<0.001) and reduced left ventricular function (p=0.002) correlated with major cardiovascular events.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Germany. Electronic address: bambul@dhm.mhn.de.
authors.forename: P
authors.initials: P
authors.lastname: Bambul Heck
authors.affiliation: Department of Cardiovascular Surgery, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pabst von Ohain
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Germany.
authors.forename: H
authors.initials: H
authors.lastname: Kaemmerer
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Germany.
authors.forename: P
authors.initials: P
authors.lastname: Ewert
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (DHM), Technische Universität München (TUM), Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hager
mesh_terms: D000328:Adult; D000367:Age Factors; D001017:Aortic Coarctation / Q000401:mortality* / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
keywords: Aortic coarctation; Cardiovascular events; Survival