Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Interventions in Adults With Repaired Coarctation of the Aorta

Blylod, Viktor Meidell ; Rinnström, Daniel ; Pennlert, Johanna ; Ostenfeld, Ellen LU orcid ; Dellborg, Mikael ; Sörensson, Peder ; Christersson, Christina ; Thilén, Ulf LU and Johansson, Bengt (2022) In Journal of the American Heart Association 11(14).
Abstract

BACKGROUND: Coarctation of the aorta coexists with other cardiac anomalies and has long-term complications, including recoarctation, which may require intervention after the primary coarctation repair. This study aims to clarify the prevalence of and risk factors for interventions related to the coarctation complex as well as late mortality in a large contemporary patient population. METHODS AND RESULTS: The Swedish National Register of Congenital Heart Disease was used, which comprised 683 adults with repaired coarctation of the aorta. Analysis was performed on freedom from intervention thereafter at the coarctation site, aortic valve, left ventricular outflow tract, or ascending aorta. One hundred ninety-six (29%) patients had at... (More)

BACKGROUND: Coarctation of the aorta coexists with other cardiac anomalies and has long-term complications, including recoarctation, which may require intervention after the primary coarctation repair. This study aims to clarify the prevalence of and risk factors for interventions related to the coarctation complex as well as late mortality in a large contemporary patient population. METHODS AND RESULTS: The Swedish National Register of Congenital Heart Disease was used, which comprised 683 adults with repaired coarctation of the aorta. Analysis was performed on freedom from intervention thereafter at the coarctation site, aortic valve, left ventricular outflow tract, or ascending aorta. One hundred ninety-six (29%) patients had at least 1 of these interventions. Estimated freedom from either of these interventions was 60% after 50 years. The risk of undergoing such an intervention was higher among men (hazard ratio, 1.6 [95% CI, 1.2– 2.2]). Estimated freedom from another intervention at the coarctation site was 75% after 50 years. In women, there was an increase in interventions at the coarctation site after 45 years. Patients who underwent one of the previously mentioned interventions after the primary coarctation repair had poorer left ventricular function. Eighteen patients (3%) died during follow-up in the register. The standardized mortality ratio was 2.9 (95% CI, 1.7–4.3). CONCLUSIONS: Interventions are common after coarctation repair. The risk for and time of interventions are affected by sex. Our results have implications for planning follow-up and giving appropriate medical advice to the growing population of adults with repaired coarctation of the aorta.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adult congenital heart disease, coarctation of the aorta, intervention, mortality, risk factors
in
Journal of the American Heart Association
volume
11
issue
14
article number
e023954
publisher
Wiley-Blackwell
external identifiers
  • pmid:35861813
  • scopus:85134855405
ISSN
2047-9980
DOI
10.1161/JAHA.121.023954
language
English
LU publication?
yes
id
d26b15c6-1ab9-4e18-bb74-5ae00dbd9c74
date added to LUP
2022-09-23 15:31:47
date last changed
2022-09-23 17:00:38
@article{d26b15c6-1ab9-4e18-bb74-5ae00dbd9c74,
  abstract     = {{<p>BACKGROUND: Coarctation of the aorta coexists with other cardiac anomalies and has long-term complications, including recoarctation, which may require intervention after the primary coarctation repair. This study aims to clarify the prevalence of and risk factors for interventions related to the coarctation complex as well as late mortality in a large contemporary patient population. METHODS AND RESULTS: The Swedish National Register of Congenital Heart Disease was used, which comprised 683 adults with repaired coarctation of the aorta. Analysis was performed on freedom from intervention thereafter at the coarctation site, aortic valve, left ventricular outflow tract, or ascending aorta. One hundred ninety-six (29%) patients had at least 1 of these interventions. Estimated freedom from either of these interventions was 60% after 50 years. The risk of undergoing such an intervention was higher among men (hazard ratio, 1.6 [95% CI, 1.2– 2.2]). Estimated freedom from another intervention at the coarctation site was 75% after 50 years. In women, there was an increase in interventions at the coarctation site after 45 years. Patients who underwent one of the previously mentioned interventions after the primary coarctation repair had poorer left ventricular function. Eighteen patients (3%) died during follow-up in the register. The standardized mortality ratio was 2.9 (95% CI, 1.7–4.3). CONCLUSIONS: Interventions are common after coarctation repair. The risk for and time of interventions are affected by sex. Our results have implications for planning follow-up and giving appropriate medical advice to the growing population of adults with repaired coarctation of the aorta.</p>}},
  author       = {{Blylod, Viktor Meidell and Rinnström, Daniel and Pennlert, Johanna and Ostenfeld, Ellen and Dellborg, Mikael and Sörensson, Peder and Christersson, Christina and Thilén, Ulf and Johansson, Bengt}},
  issn         = {{2047-9980}},
  keywords     = {{adult congenital heart disease; coarctation of the aorta; intervention; mortality; risk factors}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{14}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Interventions in Adults With Repaired Coarctation of the Aorta}},
  url          = {{http://dx.doi.org/10.1161/JAHA.121.023954}},
  doi          = {{10.1161/JAHA.121.023954}},
  volume       = {{11}},
  year         = {{2022}},
}