COARCTATION OF THE AORTA - DIFFERENT ANAT OMOCLINICAL FORMS DEPENDINGOF THE AGE OF PRESENTATION

Objective. To analyse the anatomo-clinical characteristics of the coar ctation of the aorta at different ages of presentation as well as the findings and results of its surgical correction at different periods. Patients and methods. We retrospectively studied the clinical and angi ographic data, as well as the intraoperative findings and surgical out comes of 82 consecutive patients (54 M and 28 F) with coarctation of t he aorta. Mean age was 16.2 +/- 13.7 years (1 month to 63 years). The patients were divided into three groups according to age: Group A (n = 10) under 1 year; Group B (n = 30) from 1 to 12 years and Group C (n = 42) over 12 years; Results. A preductal form was found in 20.7% case s (50.0%, 30.0% and 7.1% of groups A, B, and C respectively; p = 0.003 ). An associated left-to-right shunt was present in 19.5% (40.0%, 16.7 % and 16.7% of groups A, B and C respectively; p = NS). The first mani festation of the disease was different in groups A, B and C. Among gro up A patients, congestive heart failure was the most frequent presenta tion (70.0%). In group B, the most frequent presentation (30%) was as an incidental finding in an asymptomatic patient. Finally, systemic hy pertension or its complications predominated among group C patients (3 8.0%). Left ventricular hypertrophy on ECG was present in 0.0%, 30.0% and 54.7% of patients in groups A, B and C (p = 0.003) respectively. P ostoperative complications including death, hypertensive crisis and re -coarctation were observed in 90.0%; 33.3% and 21.4% in groups A, B an d C (p = 0.01) respectively. Conclusions. Among patients with coarctat ion of the aorta, the age of clinical presentation allows us to define groups of patients with different anatomical characteristics, clinica l course and postoperative outcome.