当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Predictors of aneurysmal formation after surgical correction of aortic coarctation.

Predictors of aneurysmal formation after surgical correction of aortic coarctation.

Abstract：

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.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

von Kodolitsch Y,Aydin MA,Koschyk DH,Loose R,Schalwat I,Karck M,Cremer J,Haverich A,Berger J,Meinertz T,Nienaber CA

doi

10.1016/s0735-1097(01)01784-3

subject

Has Abstract

pub_date

2002-02-20 00:00:00

pages

617-24

issue

eissn

0735-1097

issn

1558-3597

pii

S0735109701017843

journal_volume

pub_type

杂志文章,多中心研究

在线工具

Predictors of aneurysmal formation after surgical correction of aortic coarctation.