Surgical correction of postductal aortic coarctation in 40 adolescents and adults:A ten-year single institution experience

Background In clinical practice, there are different surgical approaches for postductal coarctation of the aorta(CoA), with their advantages and disadvantages. Limited studies have reported the surgical outcomes of postductal CoA in adolescents and adults. Methods From January 2005 to December 2014, a total of 40 patients aged over 14 years underwent surgical corrections of postductal CoA in our institution. The surgical outcomes as reflected by cardiac function and differences in mean blood pressure of upper and lower extremities both preoperative and postoperative were recorded and evaluated. Results Among the 40 patients underwent successful surgical corrections, 1 patient complicated by acute aortic dissection and died, while the remainings survived to hospital discharge. During the 12-36 month follow-up period, postoperative mean blood pressure differences of upper and lower extremities were significantly reduced as compared with the preoperative data. Postoperative evaluation of cardiac function was conducted in all patients with New York Heart Association(NYHA) I-II. Conclusion For adolescent and adult patients with postductal aortic coarctation, surgical correction is highly recommended. Surgical approach should be based on the specific anatomy of the coarctation lesion, concomitant malformations, and expected grown-up height. Those complicated with other intracardiac malformations should be treated with extra-anatomical bypass technique and simultaneous surgical correction of CoA, which is effective with desirable postoperative prognosis.