Late Aneurysms after Patch Aortoplasty for Coarctation of the Aorta in Adults

Abstract

Sixty-eight patch aortoplasties were performed for coarctation of the aorta (CoA) in adult patients from 1967 to 1978 in our hospital. The mortality was 1.5% and the immediate result of the surgical repair seemed good. Long-term follow-up of 2 to 14 years later revealed aneurysm formation at the repair area in 27% of the 62 patients for whom sufficient follow-up data are available. Two aneurysms had ruptured with a fatal outcome. Other repair methods used for coarctation in 106 patients were free from aneurysm complication. Thirteen patients with an aneurysm underwent reoperation without mortality. The etiology of these unexpected aneurysms is discussed.

Massive hemoptysis in a young man

“…Aneurysm formation rate after a patch-graft aortoplasty has been described in long-term follow-up studies (up to 15 years after surgery) to be between 3.8% and 27% (1,2). In one study, 32.8% of patients who had patch graft aortoplasty for aortic coarctation underwent reop- …”

Perpendicular Insertion of Dacron Patch for Aortoplasty in Adult Coarctation of Aorta to Increase Circular Elasticity

“…Both ridge (membrane) resection on the posterior wall of coarcted segment of aorta and stiff patch materials transmits additional tension to the adjacent elastic aortic wall, which thus bears the total burden of the pulse wave, were accused for the development of true aneurysm. [1][2][3][4][5] Backer et al 6 used polytetrafluoroethylene (PTFE) patch for patchplasty in coarctation of aorta instead of Dacron patch material. They advocated that patchplasty with PTFE does not only reduce true aneurysm incidence but also reduces the risk of recoarctation.…”

“…A true aneurysm formation from progressive deterioration of the aortic wall opposite a prosthetic patch has been reported on longterm follow-up by several authors. [1][2][3][4][5] The true aneurysm formation develops, presumably the stiff patch transmits additional tension to the adjacent elastic aortic wall, which thus bears the total burden of the pulse wave and dilates. This makes the Dacron onlay patch technique undesirable in most circumstances.…”

Coarctation of the Aorta - An Evolution of Therapeutic Options

“…4) [29][30][31][32][33]. Speculation has focused on mechanical factors affecting the wall opposite the relatively nondistensible Dacron graft, particularly in those patients with tubular hypoplasia of the transverse arch with residual gradients [31].…”