Results of Surgical Treatment of Coarctation of the Thoracic Aorta at Madani Heart Hospital: a ten year experience

To make a review of the immediate results of coarctation of the aorta (CoAo) operation, between March 1993 and October 2003 at Madani Heart Center, Tabriz-Iran. The following data were investigated: age at the time of surgery, gender, symptoms, clinical and paraclinical findings, associated cardiac lesions, and type of surgical technique, and immediate surgical outcome, particularly focusing on the presence of hypertension. Fifty three patients underwent surgical repair of CoAo. Enrolled patients had an age between 12 months to 49 years (mean 17 years), and 30 (56.6%) were male. Twenty five (47%) patients were asymptomatic. The most common presenting symptoms were palpitation (45%) and dyspnea on exertion / early fatigue (41%). The most common signs were a systolic murmur (96%), and weak lower limb pulses (86%). In electrocardiogram, 96% had signs of LV hypertrophy. The chest-X-ray was normal in only 54%. The location of coarctation was post-ductal in 78% and pre-ductal in the rest. The associated defects were present in 30 (56.6%) patients, most common being patent ductus arteriosus (26.4%) and aortic valve disease (22.4%). Among the various surgical techniques employed end-to-end anastomosis was used in 26 (49%) and Dacron patch aortoplasty in 23 patients (43.3%). During discharge BP was reduced in 75% and unchanged in 25% with respect to preoperative values. Fifteen percent of patients had some complications and one death was observed in the immediate postoperative period. There is a high rate of associated cardiac lesions with CoAo and despite a delayed diagnosis in our region; corrective surgery has a relatively good short term outcome with low morbidity and mortality.