Late Repair of Coarctation of the Descending Thoracic Aorta in 190 Patients: Results up to 30 Years After Operation

Gerald M. Lawrie, Michael E. Debakey, George C. Morris, E. Stanley Crawford, William F. Wagner, Donald H. Glaeser

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Over a 30-year period, 190 consecutive patients had repair of coarctation of the descending thoracic aorta at a mean age of 25 years (range, 1 to 60 years); 130 were male. Median preoperative blood pressure (BP) was as follows: systolic, 160 mm Hg (range, 94 to 300 mm Hg) and diastolic, 90 mm Hg (range, 50 to 160 mm Hg). Dacron grafts were used in 64.7% of patients. Follow-up was obtained at a mean interval of 84.9 months, range, one to 360 months. Survival status was established for 86.1% (163/190) of patients. Postoperatively, the median BP was 133 mm Hg systolic (range, 90 to 195 mm Hg) and 80 mm Hg diastolic (range, 50 to 120 mm Hg). Overall, 80% of patients were either normotensive or had mild hypertension after operation. The best BP response and late survival were in patients operated on under 13 years of age. This study further confirms that early operation (below 5 years of age) is desirable. However, contrary to some previous reports, patients operated on as adolescents, despite some mild residual hypertension, had an excellent long-term prognosis. Patients over 21 years of age at operation had a high rate of persistent hypertension and experienced other serious cardiovascular complications.

Original languageEnglish (US)
Pages (from-to)1557-1560
Number of pages4
JournalArchives of Surgery
Volume116
Issue number12
DOIs
StatePublished - Jan 1 1981

ASJC Scopus subject areas

  • Surgery

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