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Predictors of aneurysmal formation after surgical correction of aortic coarctation

Yskert von Kodolitsch, MD^*,*, Muhammet A. Aydin, MD^*, Dietmar H. Koschyk, MD^*, Roger Loose, MD, Ilka Schalwat, MD^*, Matthias Karck, MD, Jochen Cremer, MD, Axel Haverich, MD, J.ürgen Berger, PhD, Thomas Meinertz, MD^* and Christoph A. Nienaber, MD, FACC^*

^* Department of Internal Medicine, Division of Cardiology, Hamburg, Germany
Institute of Mathematics and Computer Science in Medicine, University Hospital Eppendorf, Hamburg, Germany
Department of Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
Department of Cardiovascular Surgery, Christian-Albrechts-University, Kiel, Germany

View larger version (119K): [in a new window]   Figure 1 Spin-echo magnetic resonance scan of marked type A aneurysmal formation after surgical correction of aortic coarctation in a patient with a bicuspid aortic valve (Patient no. 5; Table 1).

View larger version (15K): [in a new window]   Figure 2 Actuarial probability of event-free survival of patients with postsurgical aneurysms after repair of aortic coarctation. There is a trend toward a higher probability of cardiovascular events in type A aneurysms (dashed line; open triangles = censored cases) than in local aneurysms (solid line; solid triangles = censored cases) (p = 0.08). The mean event-free survival time was 104 months (95% confidence interval 70 to 137).

View larger version (18K): [in a new window]   Figure 3 (A) Receiver operating characteristic (ROC) curve analysis revealed that 13.5 years of age at the index surgical repair of coarctation was a threshold for increased risk of postsurgical aneurysmal formation. The area under the ROC curve was 0.76 (95% confidence interval 0.67 to 0.85; p < 0.0005). (B) For better identification of the cut-off age separating high and low risk, data are displayed separately for sensitivity (squares) and specificity (triangles).