Our experience with surgical repair of isolated adult aortic coarctation

Abstract

Background: Adult aortic coarctation is a relatively common congenital heart disease.
Nowadays there is trend for percutaneous management of adult aortic coarctation but the
outcome is still debatable. Objective: To assessment of the surgical outcome of isolated adult
aortic coarctation. Methods: This was a retrospective study including 18 patients who had open
surgical repair of isolated adult aortic coarctation between January 2012 and April 2018 in multiple centres in Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University. Surgery was done through left posterolateral thoracotomy with resection and interposition graft technique. Results: The mean age of patients was 29 years (range from 18-42) of them 10 were males (55.56%) and 8 were females (44.44%). Two patients (11.11%) had surgery for recoarctation and the other 16 patients (88.89%) had surgery for native coarctation. Left heart bypass was required in 4 (22.22%) patients. There was no mortality in our study group. Morbidity happened in four patients (22.22%) in the form of bleeding and re-exploration in two patients (11.11%), recurrent laryngeal nerve injury in one patient (5.56%) who had hoarseness of voice, and chylothorax in one patient (5.56%). There was no stroke, spinal cord insult (paraparesis, paraplegia), respiratory failure (reintubation, tracheostomy), renal impairment, empyema, sepsis, multiple organ failure or phrenic injury. 10 patients (55.56%) of our study group had refractory hypertension. Conclusions: Surgical repair of isolated adult aortic coarctation by resection and interposition graft technique had good outcome with no mortalities, acceptable morbidities with refractory hypertension in most of the patients.