ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical management of coarctation of aorta: 20-years experience
Hasan Basri Erdoğan, Hasan Ardal, Suat Nail Ömeroğlu, Denyan Mansuroğlu, Adil Polat, Akın İzgi, Arzu Antal, Mesut Şişmanoğlu, Mehmet Balkanay, Gökhan İpek, Esat Akıncı, Cevat Yakut
Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İstanbul
Background: The types of surgical treatment, and early and late follow-up results were retrospectively analysed in patients operated for coarctation of the aorta.

Methods: Seventy five patients (48 males, 27 females; mean age 21.05±11.98 years; range 2 month to 54 years) were operated for aortic coarctation between 1985 and 2004. Seven patients (9%) were in the infantile period, whereas 6 patients (8%) were older than 40 years. The most common presenting symptom was malaise and the most common additional pathology was aortic valve pathology in 12 patients. Forty one patients (54%) had graft aortoplasty with teflon graft, 28 (37%) had bypass grafting with PTFE graft, 1 (1.3%) had tubular graft interposition, 5 (6.6%) had resection and end-to-end anastomoses and 12 patients had undergone resection of the membrane on the posterior wall.

Results: There were 2 early and 2 late deaths (2.6% for each). Two had delayed wound healing due to infection. Chylothorax developed in one patient and pneumothorax in another one. Urgent reoperation for bleeding was performed in 2 patients. Recoarctation after resection and end-to-end anastomosis was detected in one patient that was reoperated after 4 years. Mean duration of hospital stay was 7.53±5.83 days and mean duration of follow-up was 62.31±53.96 months. Fifty seven (76%) patients had hypertension preoperatively, but in the postoperative period, only 10 patients had hypertension necessitating medical therapy.

Conclusion: Mean age of coarctation patients undergoing surgical treatment is high in our country. Despite the conflict on benefits of surgery in adulthood, our experiences show that advanced age does not bring additional problems and these patients may also benefit from surgery. However, these patients must be kept under regular surveillance for potential problems in long term.

Keywords : Aortic coarctation/surgery; heart defects, congenital; surgical procedures, operative/adverse effects
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