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Outcome after extended arch repair for aortic coarctation
  1. J D R Thomson,
  2. A Mulpur,
  3. R Guerrero,
  4. Z Nagy,
  5. J L Gibbs,
  6. K G Watterson
  1. Departments of Congenital Cardiology and Cardiac Surgery, Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
  1. Correspondence to:
    Dr John D R Thomson
    Department of Paediatric Cardiology, E floor, Jubilee Wing, Leeds General Infirmary, Leeds LS1 3EX, UK; john.thomson{at}


Objectives: To assess survival and long term arch patency rates in a consecutive group of children after extended arch repair for coarctation of the aorta.

Methods: Review of 191 consecutive children (154 (81%) under 1 year of age) operated on between 1990 and 2002 by a single surgeon using extended arch reconstructive techniques. For assessment of survival patients were divided into three groups: 1, coarctation alone, n  =  104; 2, coarctation and ventricular septal defect, n  =  38; and 3, coarctation in association with complex intracardiac anomalies, n  =  49. A prospective and systematic clinical and echocardiographic evaluation of the aortic arch was undertaken.

Results: Median time to follow up was 4.2 years (range 1–10.6 years). Overall actuarial survival was 92%, 88%, and 88% at two, five, and 10 years. Mortality was significantly higher in those patients with complex intracardiac anatomy. Arch obstruction recurred in seven of 165 (4.2%) patients: four of 139 (2.9%) term and three of 10 (30%) premature infants (p < 0.001).

Conclusions: Survival after extended arch reconstruction for coarctation is excellent. At long follow up recurrent arch obstruction is rare, with prematurity the only risk factor.

  • coarctation
  • aorta
  • surgery

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  • Published Online First 21 April 2005

  • Competing interests: None