University of Bristol, UK
Title: Case series: Paediatric repair of coarctation of the aorta and pulmonary hypertension
Natasa Chrysodonta is currently a final year medical student at the University of Bristol, and has a BSc in Medical Sciences with Management from Imperial College London. She has been awarded the Elizabeth Williams MBChB year 3 Psychiatry, Ethics & Law Prize in 2012.
Introduction: Coarctation of the Aorta (CoA) accounts for approximately 5-10% of congenital heart disease and if it remains unrepaired the median age of death is 31 years. This highlights the necessity for an early diagnosis and treatment. Despite the method of repair the outcome is highly dependent on a number of risk factors and complications. The literature lacks evidence surrounding the description in the relationship between CoA-repair and Pulmonary Hypertension (PH), with the later significantly decreasing survival. Thus it was aimed to investigate the relationship between paediatric CoA-repair and the presence of PH prior or following CoA-repair.
Methodology: A retrospective Case series was conducted at Bristol's Royal Hospital for Children (BHC). The sample was filtered through the paediatric population at BHC using specific criteria. The information required was gathered from the patients’ electronic records and the results were analysed using Microsoft Excel 2010.
Results: In total 578 records were reviewed with only 8 matching the inclusion criteria. All patients were found to have associated heart lesions and 63% underwent an additional cardiac surgical procedure, out of which 39% were associated with treating PH. Patients with pre-existing PH were found to develop more short-term complications than the post-operative PH group. The later presented with arterial PH of which early onset worsened the outcome. PH developing in adult life seemed to cause a degree of re-coarctation.
Conclusion: Despite the small size, this Case series lays the ground for future research. Further work is required to enrich our understanding and improve the health-care we provide.