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Nonductal dependent coarctation: a 20-year study of morbidity and mortality comparing early-to-late surgical repair.

OBJECTIVE
The objective of this study was to evaluate the effect of the timing of surgical repair of nonductal dependent coarctation on the short-term outcome.


METHODS
The medical records of 76 patients, diagnosed and treated for a nonductal dependent mild-to-moderate coarctation at a tertiary care institute over a 20-year period, were retrospectively reviewed with the age at repair compared against outcome measures. Multiple logistic regression was performed to assess the timing of repair, the presence of congestive heart failure or associated cardiac defects on the outcome measures.


RESULTS
The mean age of surgery for the mild-to-moderate coarctation repair was 3.1 years (range: three days to 12 years). The most common cause for referral to a pediatric cardiologist was the clinical finding of a cardiac murmur. The timing of surgical repair was not found to be a predictor of morbidity or mortality. There was no significant difference in outcome measures defined as residual hypertension, residual coarctation gradient, persistent cardiomegaly, postoperative neurological sequelae, the requirement for a second surgery or the need for balloon dilatation for residual postoperative coarctation and the need for antihypertensive medications within five years postsurgery.


CONCLUSION
The timing of surgical repair in the setting of nonductal dependent, mild-to-moderate coarctation of the aorta, does not adversely affect the short term (less than 20 years) outcome in children.