RF36 ISOLATED COARCTATION OF THE AORTA: 10 YEARS EXPERIENCE

Abstract

Introduction: Aortic coarctation (AoC) occurs in 5–7% of all congenital heart diseases. This retrospective study aims to describe mid and long-term outcomes of patients undergoing simple congenital AoC repair. Methods: We retrospectively reviewed 63 patients who underwent repair of AoC between 2008 and 2018. 40(63%) were neonates, 11 infants, 6 children, 6 adults. 29(46%) were males. 20 patients underwent end-to-end anastomosis and 33 extended end-to-end anastomosis, 8 prosthetic patch aortoplasty or prosthetic interposition grafting, 2 extra-anatomic bypass. 8 (12.7%) had bicuspid aortic valve. Patients were stratified by age and results were compared. Results: 60% of interventions were performed in emergency. Mean operation time was 129.7 minutes, mean cross-clamp time was 24.3 ± 11.4. Almost all AoC repairs were in neonates and infants with resections/extended-resections and end-to-end anastomosis while in adults we preferred prosthetic patch plasty. Major post-operative complications occurred in 7.9% and minor in 12.7% of cases. Overall mortality was 3.2%. No statistically significant differences were observed in mortality or post-operative complications incidence among patients’ groups. Mean in hospital stay was 16.6 ± 16.1days, mean ICU length of stay was 4.3 ± 6.4days. Over a mean follow-up of 4.1years, 3.2% of patients reported complications: late hypertension and aortic aneurysms. A significant gradient (>20mmHg) has been founded during follow-up in 4/63(6.3%) pediatric patients but none among adults and none of them required reoperations. No late mortality was registered. Conclusions: Long-term results of our experience confirm that surgical repair of AoC can be performed safely. End-to-end anastomosis in neonates and infants achieves excellent results if performed before occurrence of hypertension or its complications.