Long-Term Outcomes of Coarctation Repair Through Left Thoracotomy

Abstract Background Optimal surgical approach for repair of coarctation of the aorta (CoA) remains controversial. This study aims to evaluate reintervention rates and its predictors using a strategy of resection with extended end-to-end anastomosis (REEEA) via left thoracotomy. Methods A retrospective analysis was performed for all patients who underwent isolated CoA repair or CoA and simultaneous VSD repair via REEEA between Jan 2000-Dec 2015. Patients with complex congenital heart disease were excluded. Transverse arch hypoplasia was defined as echocardiographic z-score Results A total of 251 patients with median age at repair of 14.6 days met inclusion criteria. Repair was by left thoracotomy in 226 (90%). Follow-up data were available for 186/251 patients with median follow-up time of 5.4 years (range, 0.2-15.3), of which 169 (91%) underwent thoracotomy. There were no early deaths or early reoperations. A proximal transverse arch z-score Conclusions Repair of CoA even with associated transverse arch hypoplasia via REEEA through left thoracotomy has a low mortality, low reintervention rate, and low incidence of late hypertension.