Aortic aneurysm formation after coarctation repair is a serious and life-threatening complication. Repairs using synthetic materials such as
Dacron(®) may carry the highest risk of
aneurysm formation and
rupture. The authors sought to determine the prevalence of
aneurysm formation in patients who previously underwent coarctation repair using
Dacron(®) patch aortoplasty at their institution. Between 1977 and 1994, 63 patients underwent isolated coarctation repair using
Dacron(®) patch aortoplasty.
Aneurysms were defined as an aortic dimension 1.5 times that of the aorta at the level of the diaphragm as shown by angiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Of 61 early survivors, 29 (47 %) experienced an
aneurysm in the area of previous repair. Nine patients (31 %) had
spontaneous rupture of the
aneurysm, which caused death in seven cases. Elective or emergent
aneurysm repair was performed for 20 patients without complication, and 2 patients are being monitored at this writing. The mean interval from patch placement to
aneurysm repair was 15 years (range, 4-27 years). Overall freedom from the development of an
aortic aneurysm was 97 % at 5 years, 90 %
at 10 years, 69 % at 20 years, and 42 % at 25 years. After repair of coarctation using
Dacron(®) patch aortoplasty, the risk for
aneurysm formation in the area of repair and death from
rupture is extremely high. Therefore, in accordance with the 2008 American Heart Association/American College of Cardiology (AHA/ACC) guidelines, all patients with repaired
aortic coarctation should undergo either CT or MRI imaging at least every 5 years to assess for
aortic aneurysm formation. More frequent imaging should be obtained for patients previously repaired with
Dacron(®) patch aortoplasty.