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Background: The objective of this study was to determine the transplant-free survival of infants with coarctation of the aorta (CoA), the most common critical congenital heart defect.
Methods: We performed a retrospective cohort study of infants (<1 year of age) undergoing surgical intervention for CoA between 1982 and 2003 at 48 centers in 27 US states in the Pediatric Cardiac Care Consortium. Outcomes were determined from the National Death Index and the United Network for Organ Sharing through 2014. Children with associated cardiac lesions other than left-sided lesions, ventricular septal defect (VSD), patent ductus arteriosus, and atrial septal defect were excluded. We used parametric survival methods and Cox proportional hazard models to analyze outcomes.
Results: Of 2030 eligible patients with a median follow-up of 17.5 years, there were 119 deaths prior to transplant and 1 transplant, yielding an overall transplant-free survival of 94.1%. (Figure) Compared to those with simple CoA, hazard of mortality/transplant was 1.8 times higher in patients with a VSD (95% CI 1.18 – 2.82; p = 0.007) and 3.5 times higher in patients with a syndrome (95% CI 2.08 – 5.95; p < 0.001). There was no difference in transplant-free survival in patients with additional left-sided lesions vs. those with simple CoA (HR = 1.13; 95% CI 0.65 – 1.96; p = 0.67).
Conclusions: Transplant-free survival for CoA is excellent, particularly for those without a VSD or a known syndrome. Studies are underway to compare outcomes based on type of repair.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1101-009
- 2017 American College of Cardiology Foundation