Predictors of aneurysmal formation after surgical correction of aortic coarctation
Standard
Predictors of aneurysmal formation after surgical correction of aortic coarctation. / von Kodolitsch, Yskert; Aydin, Muhammet A; Koschyk, Dietmar H; Loose, Roger; Schalwat, Ilka; Karck, Matthias; Cremer, Jochen; Haverich, Axel; Berger, Jürgen; Meinertz, Thomas; Nienaber, Christoph A.
In: J AM COLL CARDIOL, Vol. 39, No. 4, 20.02.2002, p. 617-624.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Predictors of aneurysmal formation after surgical correction of aortic coarctation
AU - von Kodolitsch, Yskert
AU - Aydin, Muhammet A
AU - Koschyk, Dietmar H
AU - Loose, Roger
AU - Schalwat, Ilka
AU - Karck, Matthias
AU - Cremer, Jochen
AU - Haverich, Axel
AU - Berger, Jürgen
AU - Meinertz, Thomas
AU - Nienaber, Christoph A
PY - 2002/2/20
Y1 - 2002/2/20
N2 - OBJECTIVES: We sought to identify the predictors of aneurysmal formation after surgical correction of aortic coarctation.BACKGROUND: In 9% of patients, aneurysms develop late after corrective surgery of coarctation of the aorta, with a 36% mortality rate if left untreated. However, the predictors of postsurgical aneurysmal formation are unknown.METHODS: Of 25 aortic aneurysms requiring corrective surgery 152 +/- 78 months after the initial coarctation repair, 8 were located in the ascending aorta (type A) and 17 at the site of previous repair (local type). Seventy-four patients without progression of the aortic diameter within 189 +/- 71 months after coarctation repair were used for categorical data analysis in an attempt to identify the predictors of postsurgical aneurysmal formation.RESULTS: Advanced age at coarctation repair (p = 0.004) and patch graft technique (p < 0.0005) independently predicted local aneurysmal formation. Type A aneurysm was univariately associated with the presence of a bicuspid aortic valve (p = 0.02), advanced age at coarctation repair (p = 0.044) and a high preoperative peak systolic pressure gradient of 74 +/- 21 mm Hg (p = 0.041). Conversely, multivariate analysis confirmed only the presence of a bicuspid aortic valve (p = 0.015) as an independent predictor of type A aneurysm. Receiver operating characteristic curve analysis revealed that 72% of patients with a postsurgical aneurysm had an operation at age 13.5 years or more, whereas 69% with no postsurgical aneurysm had an operation at a younger age.CONCLUSIONS: Use of the patch graft technique and late correction of coarctation can predict aneurysmal formation at the site of coarctation repair, although patients with a bicuspid aortic valve may be at risk for an aneurysm developing in the ascending aorta, particularly after late repair of aortic coarctation with high preoperative pressure gradients.
AB - OBJECTIVES: We sought to identify the predictors of aneurysmal formation after surgical correction of aortic coarctation.BACKGROUND: In 9% of patients, aneurysms develop late after corrective surgery of coarctation of the aorta, with a 36% mortality rate if left untreated. However, the predictors of postsurgical aneurysmal formation are unknown.METHODS: Of 25 aortic aneurysms requiring corrective surgery 152 +/- 78 months after the initial coarctation repair, 8 were located in the ascending aorta (type A) and 17 at the site of previous repair (local type). Seventy-four patients without progression of the aortic diameter within 189 +/- 71 months after coarctation repair were used for categorical data analysis in an attempt to identify the predictors of postsurgical aneurysmal formation.RESULTS: Advanced age at coarctation repair (p = 0.004) and patch graft technique (p < 0.0005) independently predicted local aneurysmal formation. Type A aneurysm was univariately associated with the presence of a bicuspid aortic valve (p = 0.02), advanced age at coarctation repair (p = 0.044) and a high preoperative peak systolic pressure gradient of 74 +/- 21 mm Hg (p = 0.041). Conversely, multivariate analysis confirmed only the presence of a bicuspid aortic valve (p = 0.015) as an independent predictor of type A aneurysm. Receiver operating characteristic curve analysis revealed that 72% of patients with a postsurgical aneurysm had an operation at age 13.5 years or more, whereas 69% with no postsurgical aneurysm had an operation at a younger age.CONCLUSIONS: Use of the patch graft technique and late correction of coarctation can predict aneurysmal formation at the site of coarctation repair, although patients with a bicuspid aortic valve may be at risk for an aneurysm developing in the ascending aorta, particularly after late repair of aortic coarctation with high preoperative pressure gradients.
KW - Adolescent
KW - Adult
KW - Aorta/abnormalities
KW - Aorta, Thoracic/abnormalities
KW - Aortic Aneurysm/etiology
KW - Aortic Coarctation/complications
KW - Child
KW - Child, Preschool
KW - Female
KW - Humans
KW - Male
KW - Models, Statistical
KW - Postoperative Complications
KW - Predictive Value of Tests
KW - ROC Curve
KW - Retrospective Studies
KW - Risk Factors
KW - Time Factors
U2 - 10.1016/s0735-1097(01)01784-3
DO - 10.1016/s0735-1097(01)01784-3
M3 - SCORING: Journal article
C2 - 11849860
VL - 39
SP - 617
EP - 624
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 4
ER -
