Tratamiento quirúrgico de la coartación aórtica. Resultados a largo plazo en el Instituto Nacional de Cardiología / Sugical treatment of aortic coarctation. Long-term results at National Institute of Cardiology of Mexico

ABSTRACT

OBJECTIVES: Evaluate long-term evolution of patients submitted to surgery for coarctation of the aorta. Compare event free survival in younger vs older patients at the time of surgical correction. METHODS: We reviewed the clinical records of patients operated for coarctation of the aorta from January 1 1980 to December 31 1994. The mean follow-up ranged from 9 to 23 years (mean 10.9 y). Final events registered were recoarctation, death, systemic hypertension, endocarditis, stroke, aneurisms. RESULTS: Two hundred and sixteen patients were found with mean age 13 +/- 12 y male gender was most frequent (61%). Recoarctation was found in 13 patients (6.02%), persistent hypertension in 14.1%. Event free survival at 10 years was 86.2%. In patients less than 10 y was 89% vs 80.2% in older patients. Hypertension free survival in patients less than 10 y was 98.3% vs 80.1% in older patients (p < 0.001). CONCLUSIONS: Our data confirms that surgical treatment for coarctation of the aorta is associated with low morbidity and mortality at long-term with reduced rate of recoarctation (7%). Early correction (< 10 y) is associated with a better long term survival. Hypertension and use of pharmacologic treatment are reduced after surgery and persist in the long-term evolution.