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Aortic aneurysms remain a significant source of morbidity and mortality after use of Dacron(®) patch aortoplasty to repair coarctation of the aorta: results from a single center. Pediatr Cardiol 2013 Feb;34(2):296-301

Date

07/31/2012

Pubmed ID

22843204

DOI

10.1007/s00246-012-0442-1

Scopus ID

2-s2.0-84879505874   23 Citations

Abstract

Aortic aneurysm formation after coarctation repair is a serious and life-threatening complication. Repairs using synthetic materials such as Dacron(®) may carry the highest risk of aneurysm formation and rupture. The authors sought to determine the prevalence of aneurysm formation in patients who previously underwent coarctation repair using Dacron(®) patch aortoplasty at their institution. Between 1977 and 1994, 63 patients underwent isolated coarctation repair using Dacron(®) patch aortoplasty. Aneurysms were defined as an aortic dimension 1.5 times that of the aorta at the level of the diaphragm as shown by angiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Of 61 early survivors, 29 (47 %) experienced an aneurysm in the area of previous repair. Nine patients (31 %) had spontaneous rupture of the aneurysm, which caused death in seven cases. Elective or emergent aneurysm repair was performed for 20 patients without complication, and 2 patients are being monitored at this writing. The mean interval from patch placement to aneurysm repair was 15 years (range, 4-27 years). Overall freedom from the development of an aortic aneurysm was 97 % at 5 years, 90 % at 10 years, 69 % at 20 years, and 42 % at 25 years. After repair of coarctation using Dacron(®) patch aortoplasty, the risk for aneurysm formation in the area of repair and death from rupture is extremely high. Therefore, in accordance with the 2008 American Heart Association/American College of Cardiology (AHA/ACC) guidelines, all patients with repaired aortic coarctation should undergo either CT or MRI imaging at least every 5 years to assess for aortic aneurysm formation. More frequent imaging should be obtained for patients previously repaired with Dacron(®) patch aortoplasty.

Author List

Cramer JW, Ginde S, Bartz PJ, Tweddell JS, Litwin SB, Earing MG

Authors

Peter J. Bartz MD Professor in the Pediatrics department at Medical College of Wisconsin
Salil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aortic Aneurysm, Thoracic
Aortic Coarctation
Blood Vessel Prosthesis
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Morbidity
Polyethylene Terephthalates
Postoperative Complications
Prognosis
Reconstructive Surgical Procedures
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Tomography, X-Ray Computed
United States
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a