{"doi":"10.1016/j.xjse.2024.100034","title":"Primary aortic coarctation repair in adolescents and adults","abstract":"Objective Optimal management of primary aortic coarctation in adolescents and adults remains controversial. We assess early and late mortality of repair, longitudinal antihypertensive regimens, and freedom from reintervention for repair-related complications. Methods From January 1, 1999, to July 1, 2023, 110 adolescents or adults, mean age 39 ± 16 years, underwent primary aortic coarctation repair at Cleveland Clinic. Patients were grouped by repair strategy: stented (60, 55%), grafted (interposition graft or extra-anatomic bypass; 36, 33%), or other (14, 13%). Longitudinal antihypertensive regimens were assessed parametrically. Freedom from reintervention and survival were assessed by the Kaplan–Meier method. Median follow-up for survival was 9.2 years. Results One patient (0.91%) died in-hospital. Major morbidity included stroke (2/107, 1.9%), tracheostomy (2/107, 1.9%), acute renal failure requiring dialysis (1/108, 0.93%), iatrogenic aortic dissection (1/107, 0.93%), and vascular access complication (1/56, 1.8%). Prevalence of patients requiring zero antihypertensive medications postoperatively peaked within 2 years. Twelve-year freedom from reintervention was 69% in the stented group and 97% in the grafted group ( P log-rank = .003). Most reinterventions were for in-stent restenosis of bare metal stents. Overall freedom from reintervention at 1, 5, and 12 years was 91%, 80%, and 76%, respectively. Overall survival was 98%, 95%, and 80% at 5, 10, and 14 years, respectively. Conclusions A tailored approach to coarctation repair in adolescents and adults using stented repair when anatomically feasible yields excellent short-term outcomes, but patients require persistent hypertension monitoring and have lower than expected long-term survival. Covered stents or stent grafts are preferred to bare metal stents, which are subject to in-stent restenosis.","journal":"JTCVS structural and endovascular.","year":2024,"id":482062,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.934,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":426990,"name":"William C. Frankel","orcid":"0000-0002-3991-928X","position":1,"is_corresponding":false},{"id":1322717,"name":"Jonathan Putnam","orcid":null,"position":2,"is_corresponding":false},{"id":1322718,"name":"Holliann Willekes","orcid":null,"position":3,"is_corresponding":false},{"id":1076016,"name":"Benjamin Kramer","orcid":"0000-0002-1672-5386","position":4,"is_corresponding":false},{"id":917215,"name":"Ashley M. Lowry","orcid":"0000-0001-9578-6859","position":5,"is_corresponding":false},{"id":519159,"name":"Tara Karamlou","orcid":"0000-0001-9315-7821","position":6,"is_corresponding":false},{"id":1322386,"name":"Patcharapong Suntharos","orcid":"0000-0003-3412-4637","position":7,"is_corresponding":false},{"id":874739,"name":"Joanna Ghobrial","orcid":"0000-0003-2596-1935","position":8,"is_corresponding":false},{"id":262187,"name":"Lars G. Svensson","orcid":"0000-0002-5749-4588","position":9,"is_corresponding":false},{"id":3775,"name":"Eugene H. Blackstone","orcid":"0000-0001-9839-3567","position":10,"is_corresponding":false},{"id":514676,"name":"Eric E. Roselli","orcid":"0000-0003-1533-7987","position":11,"is_corresponding":false},{"id":574449,"name":"Matthew A. Thompson","orcid":"0000-0002-4843-3513","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:07:14.349221Z","pmid":"42305376","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}