Original article: cardiovascularCoarctation of the aorta in adults: surgical results and long-term follow-up
Section snippets
Material and methods
Between 1977 and 1997, 35 adult patients older than 20 years underwent repair of aortic isthmic coarctation. There were 23 men and 12 women with a mean age of 30.8 ± 5.7 years (range, 21 to 52 years). Preoperative findings are summarized in Table 1. Eleven patients (31%) presented with at least one symptom. For the other 24 patients, the diagnosis made by physical examination was prompted by the discovery of high blood pressure. Clinical findings were a systolic murmur in 4 patients, and
Postoperative follow-up
There was no surgical mortality. Morbidity included two recurrent nerve palsies and one reoperation for bleeding. The mean length of follow-up was 13.8 ± 4.6 years (range, 1.4 to 22 years). One patient was lost to follow-up. At the most recent follow-up, all patients were alive. Thirty-two patients (94%) were symptom free (New York Heart Association class I) and leading a normal lifestyle; only 5 patients were unemployed. Two patients had angina pectoris and 1 patient had myocardial infarction.
Natural history
The natural history of coarctation has been well documented by Campbell [11], who demonstrated that 50% of untreated patients were dead by the age of 30 years, 75% at 46 years, and 90% at 58 years. Comparing these data with normal life expectancy tables we observed that there was a high increase in mortality during the third to fifth decades of life. Presbitero and coworkers [3], whose postoperative follow-up ranged from 15 to 30 years, reported improved life expectancy after operation.
Operative procedure
In this
Acknowledgements
We thank Richard Medeiros for his valuable advice on editing the manuscript.
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