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Heart. 2006 Jan;92(1):90-4. Epub 2005 Apr 21.

Outcome after extended arch repair for aortic coarctation.

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  • 1Department of Congenital Cardiology, Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK. john.thomson@lineone.net

Abstract

OBJECTIVES:

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.

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