초록접수 현황
| 16F-258 | 포럼 발표 |
Outcomes of Surgical Repair of Coarctation of the Aorta after Childhood
Hyo Hyun Kim, Yu Rim Shin, Young Ho Yang, Young-Hwan Park, Han Ki Park
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Uncorrected coarctation of the aorta (CoA) is associated with reduced life expectancy secondary to heart failure, hypertension related complications and infective endocarditis. To determine the mid and long-term outcome after surgical repair of coarctation after childhood (≥15 years old), we retrospectively reviewed out data.
Methods : Between 2000 and 2016, 20 patients underwent surgical repair for CoA. The mean age was 26.2± 11.8 years (range, 15 to 55). Four (20%) patients had history of previous cardiac operations. One patient had re-coarctation after repair CoA in neonatal period. All patients were hypertensive before surgical intervention (mean systolic blood pressure 151 mmHg; mean pressure difference of limbs 34 mmHg). The peak systolic pressure gradient across the coarctation was 49 ± 13 mmHg. Surgical techniques were graft interposition (n=17), patch enlargement (n=1), extra-anatomic bypass (n= 1), and revision of sliding aortoplasty (n=1).
Results : There was no surgical or late mortality. Postoperatively, all patients required intensive blood pressure management using intravenous vasodilators. Major morbidities were as cerebral infarction (10%), vocal cord palsy (5%) and postcoarctectomy syndrome (5%). Older age was the risk factor for major postoperative morbidities (p=0.024). Follow-up duration was 39 ± 45 months. The systolic blood pressure was significantly improved (p<0.001). Although most patients are taking antihypertensive medications, the number of medications decreased and all patients became normotensive.
Conclusion : Surgical repair of CoA is an effective treatment to relieve hypertension even after childhood. In older patients, care should be paid to prevent postoperative major morbidities.
Methods : Between 2000 and 2016, 20 patients underwent surgical repair for CoA. The mean age was 26.2± 11.8 years (range, 15 to 55). Four (20%) patients had history of previous cardiac operations. One patient had re-coarctation after repair CoA in neonatal period. All patients were hypertensive before surgical intervention (mean systolic blood pressure 151 mmHg; mean pressure difference of limbs 34 mmHg). The peak systolic pressure gradient across the coarctation was 49 ± 13 mmHg. Surgical techniques were graft interposition (n=17), patch enlargement (n=1), extra-anatomic bypass (n= 1), and revision of sliding aortoplasty (n=1).
Results : There was no surgical or late mortality. Postoperatively, all patients required intensive blood pressure management using intravenous vasodilators. Major morbidities were as cerebral infarction (10%), vocal cord palsy (5%) and postcoarctectomy syndrome (5%). Older age was the risk factor for major postoperative morbidities (p=0.024). Follow-up duration was 39 ± 45 months. The systolic blood pressure was significantly improved (p<0.001). Although most patients are taking antihypertensive medications, the number of medications decreased and all patients became normotensive.
Conclusion : Surgical repair of CoA is an effective treatment to relieve hypertension even after childhood. In older patients, care should be paid to prevent postoperative major morbidities.
책임저자: Han Ki Park
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Hyo Hyun Kim, E-mail : ysgs@yuhs.ac