My study included 562 patients with coarctation of the aorta who had surgical repair at the at the thoracic surgery department, Rikshospitalet between 1971 an 2004.
I found that the mean age for the primary operation was 2,965 years (2 years and 347 days). For those who needed a reoperation, the mean number of years form the primary operation to the second operation was 7,238 years (7 years and 85 days).
97 out of 562 (17,3 %) died from various reasons. 82,4 % were still alive at the end of my study. The mean age at death was 3,980 years (3 years and 352 days). The mean time from the primary operation to death was 2,827 years (2 years and 297 days).
I registered different types of surgical techniques. For the primary operation, patch plasty and end-to-end anastomosis was the two most frequently used, patch plasty with 57,8 % (325 patients) and ETEA with 33,3 % (187 patients). The other techniques used were aortaplasty, insertion of a tube graft, the subclavian flap procedure and the extended ETEA. 48 out of the 81 patients who were reoperated had a redo patch-plasty done.
I also registered associated lesions. 255 patients were registered as simple coarctation, 307 of the patients had en or more associated heart lesions. Persistent ductus ateriosus was present in 37,2 % (209 patients), ventricle septum defect was present in 24 % (135 patients). 5,2 % had a transposition of the great arteries, 5,2 % had aortic valve abnormalities and 3,5 % had mitral abnormalities,
Although operative repair for aortic coarctation has been preformed since 1945, studies have shown that survivors have decreased life expectancy and many late cardiovascular complications. Late complications commonly include systemic hypertension, premature atherosclerosis, aortic valve or mitral anomaly, recoarctation and aortic aneurysms. Several studies, including my own paper, emphasizes the importance of regular follow-ups of these patients, especially patients operated with Dacron patch plasty. It seems like a clinic evaluation and MR/CT imaging in all patients or all patients with positive results by echocardiogram is the most cost-efficient approach to this challenge.