Posttransplant recoarctation of the aorta: a twelve year experience

Objectives. This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation. Background. Patients with ao...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of the American College of Cardiology Vol. 32; no. 2; pp. 509 - 514
Main Authors:	Shirali, Girish S., Cephus, Constance E., Kuhn, Micheal A., Ogata, Kay K., Vander Dussen, Laura K., Chinnock, Richard E., Mulla, Neda F., Johnston, Joyce K., Bailey, Leonard L., Gundry, Steven R., Razzouk, Anees J., Larsen, Ranae L.
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-08-1998 Elsevier Science
Subjects:	Adolescent Angioplasty, Balloon Aorta, Thoracic - abnormalities Aorta, Thoracic - surgery Aortic Coarctation - diagnosis Aortic Coarctation - diagnostic imaging Aortic Coarctation - etiology Aortic Coarctation - surgery Aortic Coarctation - therapy Biological and medical sciences Cardiology. Vascular system Child Child, Preschool Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Disease-Free Survival Echocardiography Female Follow-Up Studies Forecasting Heart Heart Transplantation - adverse effects Heart Transplantation - diagnostic imaging Humans Hypertension - diagnosis Hypertension - etiology Incidence Linear Models Male Medical sciences Postoperative Complications Recurrence Retrospective Studies Risk Factors Safety Survival Rate HLHS Sonography Human Heart Hypoplasia Reconstruction Reoperation Echocardiography Cardiovascular disease Transplantation Homotransplantation Congenital disease Treatment Malformation Heart disease Surgery Aortic arch Complication Diagnosis Child Aortic disease
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Objectives. This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation. Background. Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta. Methods. This was a retrospective review of all children (age <18 years) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the most recent follow-up assessment of the aortic arch. Results. Two hundred eighty-eight transplants were performed on 279 children (follow-up = 1,075 patient-years; range 0 to 133 months, median 43.7). Thirty-two of 152 patients (21%) who underwent extended aortic arch reconstruction subsequently developed recoarctation. All but one patient developed recoarctation within 2 years after transplant; 87% were hypertensive at presentation. Of 30 patients who underwent intervention for recoarctation (balloon angioplasty [n = 26] and surgical repair of recoarctation [n = 4]), 26 (87%) have remained recurrence-free (follow-up = 133 patient-years; range 8 to 106 months, median 47). Conclusions. The high frequency of recoarctation after cardiac transplantation with extended aortic arch reconstruction mandates serial echocardiographic evaluation of the aortic arch. Patients typically present with systemic hypertension within the first two years after transplantation. Balloon angioplasty is a safe, effective and durable method of treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/S0735-1097(98)00235-6