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Dijkema EJ, Dik L, Breur JMP, et al. Two decades of aortic coarctation treatment in children; evaluating techniques. Neth Heart J. 2020;29(2):98-104doi: 10.1007/s12471-020-01513-y.
Dijkema, E. J., Dik, L., Breur, J. M. P., Sieswerda, G. T., Haas, F., Slieker, M. G., & Schoof, P. H. (2021). Two decades of aortic coarctation treatment in children; evaluating techniques. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 29(2), 98-104. https://doi.org/10.1007/s12471-020-01513-y
Dijkema, E J, et al. "Two decades of aortic coarctation treatment in children; evaluating techniques." Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation vol. 29,2 (2021): 98-104. doi: https://doi.org/10.1007/s12471-020-01513-y
Dijkema EJ, Dik L, Breur JMP, Sieswerda GT, Haas F, Slieker MG, Schoof PH. Two decades of aortic coarctation treatment in children; evaluating techniques. Neth Heart J. 2021 Feb;29(2):98-104. doi: 10.1007/s12471-020-01513-y. Epub 2020 Nov 11. PMID: 33175331; PMCID: PMC7843778.
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Neth Heart J. 2021 Feb;29(2):98-104. doi: 10.1007/s12471-020-01513-y. Epub 2020 Nov 11.

Two decades of aortic coarctation treatment in children; evaluating techniques.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

E J Dijkema, L Dik, J M P Breur, G T Sieswerda, F Haas, M G Slieker, P H Schoof

Affiliations

  1. Department of Pediatric Cardiology, Wilhelmina Children's Hospital (WKZ), University Medical Center Utrecht, Utrecht, The Netherlands. [email protected].
  2. Department of Pediatric Cardiology, Wilhelmina Children's Hospital (WKZ), University Medical Center Utrecht, Utrecht, The Netherlands.
  3. Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  4. Department of Cardiothoracic Surgery, Wilhelmina Children's Hospital (WKZ), University Medical Center Utrecht, Utrecht, The Netherlands.

PMID: 33175331 PMCID: PMC7843778 DOI: 10.1007/s12471-020-01513-y

Abstract

OBJECTIVE: This study focuses on the evolution of treatment techniques for aortic coarctation in children and assesses long-term morbidity.

METHODS: This retrospective cohort study evaluates patients treated for native aortic coarctation, with at least 7 years of follow-up. To assess time-related changes, three time periods were distinguished according to year of primary intervention (era 1, 2 and 3). Operative and long-term follow-up data were collected by patient record reviews.

RESULTS: The study population consisted of 206 patients (177 surgical and 29 catheter-based interventions), with a median follow-up of 151 months. Anterior approach with simultaneous repair of aortic arch and associated cardiac lesions was more common in the most recent era. Median age at intervention did not change over time. Reintervention was necessary in one third of the cohort with an event-free survival of 74% at 5‑year and 68% at 10-year follow-up. Reintervention rates were significantly higher after catheter-based interventions compared with surgical interventions (hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.04-3.00, p = 0.04) and in patients treated before 3 months of age (HR 2.1, 95% CI 1.27-3.55, p = 0.003). Hypertension was present in one out of five patients.

CONCLUSION: Nowadays, complex patients with associated cardiac defects and arch hypoplasia are being treated surgically on bypass, whereas catheter-based intervention is introduced for non-complex patients. Reintervention is common and more frequent after catheter-based intervention and in surgery under 3 months of age. One fifth of the 206 patients remained hypertensive.

Keywords: Cardiothoracic surgery; Coarctation; Congenital heart disease; Endovascular stent placement

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