Clinical outcomes after coarctation surgery in a pediatric population at Heart Center Leipzig - A two-decade experience.

BACKGROUND

Aortic coarctation (CoA) accounts for 5%-8% of congenital heart defects, and patients' symptoms can range from neonatal shock to hypertension in adolescence or even adulthood. While surgical repair is the gold standard, catheter-based therapies are increasingly utilized. Despite advancements, complications, and recurrence rates necessitating re-intervention remain concerns.

PATIENTS AND METHODS

We analyzed the postoperative outcomes and long-term intervention rates for pediatric patients undergoing extended end-to-end CoA repair without cardiopulmonary bypass between October 2002 and January 2024 at the Leipzig Heart Center. Data were prospectively collected and retrospectively analyzed.

RESULTS

Among 168 patients, the median age at surgery was 11 days (interquartile range [IQR] 6-26). There was no early mortality. Median intensive care unit stay was 4 days (IQR 3-5), and hospital stay was 9 days (IQR 7-12). Early re-intervention during the same hospital stay was required in 3% due to re-coarctation. Median follow-up was 33 months (IQR 7 months-8 years). Long-term survival at 1, 5, 10, and 14 years was 100%, 98.9%, 98.9%, and 98.9%, respectively. Freedom from catheter-based intervention was 74.3%, 70.1%, 67.9%, and 64.8% at the same intervals.

CONCLUSION

Extended end-to-end anastomosis for CoA repair in children yields excellent survival and acceptable long-term outcomes, though re-intervention remains a consideration.