Surgical repair of coarctation of the aorta, first successfully performed more than 30 years ago, generally has been considered curative. Yet persistent hypertension and unexpected mortality in some patients have raised questions about the long-term success of this operation in adults.
A 30-year (1947 to 1976) retrospective study of 114 adults who underwent such operations at three University of Toronto hospitals shows that there is a significantly higher rate of complications and mortality in patients who were older than 25 years at the time of surgery.
The average age for surgery in the younger-than25-years group was 19.4 years, and the follow-up period was 10.8 years. In the older-than-25-years group, the average age at surgery was 34.97 years, with follow-up carried out 10.0 years later.
Reporting in Miami to the American College of Cardiology, chief investigator John P. Rowen, MD, said that of the "over-25" patients, only 28% were normotensive at