Echocardiographic predictors of recoarctation following surgical repair – a Swedish national study

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Bibtex

@article{09acc3158b894c9185e77318c9e9d0e8,
title = "Echocardiographic predictors of recoarctation following surgical repair – a Swedish national study",
abstract = "Background Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms. Methods Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017. Results 253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Z-scores combined with surgical and demographic factors. We defined reCoA risk categories as low (≤10%), moderate (11-29%), moderate-high (30-49%) and high (≥50%). Patients with a) isthmus ≤3.3mm (1- and 5-year event free survival 38 and 32%) or b) isthmus Z-score ≤-2.8 with a weight at surgery <4.4kg (1- and 5-year event free survival 21 and 16%) were at highest risk for reCoA. Conversely, patients at low risk had a) isthmus >3.7mm and distal aortic arch >3.5mm (1- and 5-year event free survival 97 and 97%), and b) isthmus and proximal aortic arch Z-score >-2.8 or operative weight >4.4kg with an isthmus Z-score <=-2.8 with (1- and 5-year event free survival 97 and 97%). Conclusion ReCoA risk can be predicted based on postoperative pre-discharge echocardiographic variables in combination with surgical and demographic factors. We suggest tailoring follow-up intervals individually according to the predicted reCoA risk.",
author = "Weismann, {Constance G.} and Bernhard Grell and Michal Odermarsky and Mats Mellander and Petru Liuba",
year = "2021",
doi = "10.1016/j.athoracsur.2020.05.062",
language = "English",
volume = "111",
pages = "1380--1386",
journal = "Annals of Thoracic Surgery",
issn = "1552-6259",
publisher = "Elsevier",
number = "4",

}