Presbitero P, Demarie D, Villani M, Perinetto E A, Riva G, Orzan F, Bobbio M, Morea M, Brusca A
Br Heart J. 1987 May;57(5):462-7. doi: 10.1136/hrt.57.5.462.
The late outcome in 226 patients who survived surgical repair of aortic coarctation was assessed 15-30 years after operation. Twenty six patients died during the follow up mainly from causes related to surgical repair or to associated cardiovascular anomalies. The survival rates of patients operated on between the ages of four and 20 years are 97%, 97%, 92% at 10, 20, and 30 years after operation. For patients operated on after the age of 20 the corresponding rates are 93%, 85%, and 68%. This difference is statistically significant from the fifteenth year of follow up onwards. The survival of patients operated on before the age of 20 is not significantly different from that of a comparable general Italian population. Recoarctation occurred in only 8% of patients who had end to end anastomosis, whereas it occurred in 35% of those who had other types of operation. Two thirds of the patients were hypertensive at the last visit. The actuarial curve shows that blood pressure was normal in most patients 5-10 years after operation, but 30 years after coarctation repair only 32% of patients are expected to be normotensive. Thus early repair of aortic coarctation appears to improve long term survival. Intervention in older patients and when blood pressure is high seem to be the most important predictors of late hypertension.
对226例主动脉缩窄手术修复术后存活的患者，在术后15至30年进行了远期预后评估。26例患者在随访期间死亡，主要死因与手术修复或相关心血管畸形有关。4至20岁接受手术的患者在术后10年、20年和30年的生存率分别为97%、97%和92%。20岁以后接受手术的患者相应的生存率分别为93%、85%和68%。从随访第15年起，这种差异具有统计学意义。20岁以前接受手术的患者的生存率与意大利普通可比人群的生存率无显著差异。端端吻合的患者中只有8%发生再缩窄，而接受其他类型手术的患者中这一比例为35%。三分之二的患者在最后一次就诊时患有高血压。精算曲线显示，大多数患者在术后5至10年血压正常，但在缩窄修复术后30年，预计只有32%的患者血压正常。因此，主动脉缩窄的早期修复似乎能提高长期生存率。老年患者和血压高时进行干预似乎是晚期高血压最重要的预测因素。
