Shi-Min Yuan1, Ehud Raanani. 1. Department of Cardiac and Thoracic Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel. shi_min_yuan@yahoo.com
Abstract
BACKGROUND: The mechanism of the late complications after coarctation repair remains unclear, and this common congenital heart disease affects patients and perplexes physicians in terms of prevention and treatment. METHODS: From 2004 to 2008, 13 patients (1 adolescent and 12 adults) with repaired or unrepaired coarctation of the aorta were operated on in this department due to valve disorder or aortic aneurysm. RESULTS: The late complications were mitral and tricuspid regurgitation with congestive heart failure in 1, aortic valve disorder in 4, ascending aortic aneurysm in 3, saccular arch aneurysm in 1, and pseudoaneurysm in ascending, at isthmus, and descending aorta (Ortner's syndrome) in 1 patient each, respectively. Recoarctation occurred in 3 (25%) patients, 23, 29, and 36 years after coarctation repair. One patient had persistent hypertension. CONCLUSIONS: Patients with repaired coarctation of the aorta may eventually develop late complications including valve disorders, aortic aneurysm or pseudoaneurysm, in adolescence or adulthood, especially in the patient population associated with bicuspid aortic valve or complex congenital heart defects. Patients with unrepaired coarctation of the aorta, who can live to adulthood easily, may have a lack of associated anomalies. A regular follow-up is recommended for the patients with coarctation of the aorta in order to have a full-scope observation and prompt treatment when necessary.
BACKGROUND: The mechanism of the late complications after coarctation repair remains unclear, and this common congenital heart disease affects patients and perplexes physicians in terms of prevention and treatment. METHODS: From 2004 to 2008, 13 patients (1 adolescent and 12 adults) with repaired or unrepaired coarctation of the aorta were operated on in this department due to valve disorder or aortic aneurysm. RESULTS: The late complications were mitral and tricuspid regurgitation with congestive heart failure in 1, aortic valve disorder in 4, ascending aortic aneurysm in 3, saccular arch aneurysm in 1, and pseudoaneurysm in ascending, at isthmus, and descending aorta (Ortner's syndrome) in 1 patient each, respectively. Recoarctation occurred in 3 (25%) patients, 23, 29, and 36 years after coarctation repair. One patient had persistent hypertension. CONCLUSIONS:Patients with repaired coarctation of the aorta may eventually develop late complications including valve disorders, aortic aneurysm or pseudoaneurysm, in adolescence or adulthood, especially in the patient population associated with bicuspid aortic valve or complex congenital heart defects. Patients with unrepaired coarctation of the aorta, who can live to adulthood easily, may have a lack of associated anomalies. A regular follow-up is recommended for the patients with coarctation of the aorta in order to have a full-scope observation and prompt treatment when necessary.