Abstracts Health Sciences

Congenital Malformations of the Aortic Arch and Isthmus : A retrospective study of 588 patients undergoing surgery for Aortic Coarctation or Interrupted Aortic Arch at Rikshospitalet from 1971 to 2001

by Trond Meland

Bakcground: This quality-control study includes patients operated for Coarctation of the Aorta or Interrupted Aortic Arch at Rikshospitalet between 1971 and 2001 to give a comprehensive presentation of the material and identify predictors for death and for re-operation free survival Methods: 588 patients were identified, information was obtained from databases, registries and patient records, then analyzed with Kaplan-Meier, univariate and multivariate regression analysis to identify risk factors. Results: Fwup completeness was (99,3%), median fwup time was 19,15 years. There were 348 boys (59,2%) and 240 girls (40,8%), 425 had isolated CoA (72,2%), 108 had hypoplasia (18,4%), 55 had IAA (9,4%) Age at initial repair was <1 month in 244 (41,5%), between 1 month and one year in 126 (21,4%), >1 year in 218 (37,1%). 330 was considered to be in comorbidity group I (56,1%), 130 in group II (22,1%), 128 in comorbidity group III (21,8%) There were 59 early deaths (9,4%) and a total mortality of 20,6%. Operation in early time period, comorbidity group III, median sternotomy approach and surgery in the neonatal period predicted death. 113 patients (19,2%) were re-operated at a median time of 8,09 years after initial surgery. Re-operation free survival was 55% 30-35 after inital repair. Risk factors for death or re-operation was early time period, hypoplasia, interrupted arch, group III comorbidity and repair at neonatal age. Conclusions: Mortality after surgical repair of Coa and IAA is linked to coexisting cardiac malformations. Hypoplasia of the aortic arch strongly predispose for re-operation.