ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
REPAIR OF ADULT AORTIC COARCTATION WITH PATCH PLASTY: MID AND CONGTERM RESULTS
Melih H. US, Yılmaz CİNGÖZBAY, Kaan İNAN, Arif TARHAN, Ahmet BALTALARLI, Turan EGE, Mutasım SÜNGÜN, Ömer Y. ÖZTÜRK
Gülhane Askeri Tıp Akademisi, Haydarpaşa Eğitim Hastanesi, Kalp Damar Cerrahisi Bölümü, İSTANBUL
Purpose:

The technique of patch aortoplasty is still one of the popular methods in adult patients. Patch repair using prosthetic material may lead to aneurysm formation in the long term. Between January 1988- October 1999, 62 adult patients had been operated and 58 were operated by this technique in Gülhane Military Medical Academy, Haydarpaşa Training Hospital. Here we present the mid-long term results of this experience.

Materials and Methods:

There were 52 men (%90) and 6 women (%10). All the patients were hypertensive, and had systolic hypertension about 175±19 mmHg. Preoperatively aortography was performed routinely. Systolic gradient at the level of coarctation was 95±25 mmHg. Posterior intimal shelf was not resected in order to preserve posterior wall integrity. Teflon patch was used as a patct material.

Results:

There were no mortality and no postoperative neurologic sequele. Hypertension was still present in 42 patients (%72.5) in the early postoperative period, which was controlled by medication. Patients were followed-up about 6.7±2 year. Antihypertensive medication was uased on on an awege of 14±4 months of the therapy. During the outpatient angiographic controls, recurrent stenosis was detected in 4 patients (%6.8). No aneurysmal dilatation developed.

Conclusion:

Adult patiens with coarctation of the aorta should be treated to prevent morbidity and mortality which may develop secondary to hypertension. Patch repair of the aorta is a well-established and easy method in the treatment of adult patients. Posterior intimal shelf should not be resected in order to prevent posterior wall weakness.

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