IJCS | Volume 33, Nº1, January / February 2019

5 Table 1 - Baseline characteristics of patients (n = 72) who underwent surgical correction of coarctation of the aorta at the HC-UNICAMP between June 1996 and November 2016 Demographic data Age at surgery, years 5.64 ± 1.31 (0.1 to 27) Male, % 41/ 72 (56.9) Follow-up time, years 5.82 ± 0.86 (0.02 to 20) Clinical data Symptomatic, % 36/60 (60) Hypertensive, % 27/46 (58.7) Heart murmur, % 51/58 (87.9) Absence of lower limbs pulse, % 23/47 (48.9) Surgical data Hospitalization, days 10.3 ± 1.07 (4 to 32) Surgery time, hours 2.3 ± 0.09 (1.5 to 3.5) Clamping time, min 15.9 ± 6 (8 to 38) Data expressed as mean ± SE (range) or n/total (%). Complications include injury to adjacent structures, suchas the common thoracicduct, leading tochylothorax. 13 Also, paraplegia may occur in 0.5% of cases, especially in those requiring prolonged cross-clamping time or presenting with distal hypotension. 13 Lately, up to one- third of operated patients may develop recoarctation, which worsens the prognosis and require prompt intervention. If uncomplicated, the procedure should take from 2 to 3 hours, with a mean cross-clamping time of 17 minutes. 14 Missing data Only data collected from the medical records of our hospital and only tests performed at our institution were considered for analysis. Therefore, patients diagnosed or followed in other centers and referred to the HC-UNICAMP for surgical correction, had missing data and were lost to follow-up. To tackle this issue, data is presented according to the total number of tests available. Statistical analysis Kolmogorov-Smirnoff test was applied to classify data as parametric or non-parametric. Parametric data were expressed as mean and standard error, and non- parametric data as median and interquartile range. Categorical variables were expressed as number of cases and prevalence (%). Continuous variables were analyzed using paired t-tests, and categorical variables were compared by chi-square test. For all analysis, a p-value of less than 0.05 was considered statistically significant. Statistical analysis was performed using SPSS, version 20.0 (IBM, Chicago, IL, USA). Results We identified 72 patients who underwent CoA surgical correction at the HC-UNICAMP between June 1996 and November 2016. Patients were followed for a mean time of 5.82 years, ranging from 0 to 20 years. The mean age at surgery was 5.64 ± 1.31 years, ranging from 0.1 to 27 years, and 51.6% of patients were operated in their first year of life. Demographic data is summarized in Table 1. At diagnosis, 51 (87.9%) patients had a heart murmur and 23 (48.9%) had no palpable pulse in the lower limbs. Out of the 18 electrocardiographic tests performed, 12 (67%) patients with LV overloadwere detected, and of 14 patients who underwent complementary cardiovascular imaging investigation beyond echocardiogram, two (14%) had a chest X-ray, one (7%) had a chest computed tomography and six (43%) underwent computed tomography angiography. Besides, among those taking antihypertensive medications at baseline (58%), the most frequent classes were thiazide diuretics (35.6%), beta-blockers (27.1%) and inhibitor of angiotensin- converting enzyme inhibitors (22%). Use of vasodilators (5.1%) and angiotensin receptor blocker (1.7%) were far less common (Table 2). At baseline, the mean peak DAG was 55 mmHg, and 19 (78%) of patients had LV hypertrophy. The most common echocardiographic findings were bicuspid aortic valve (BAV) (32.8%), persistent arterial duct (31%) and interventricular communication (19%). Mitral valve insufficiency was present in 13.8% of patients. Noteworthy, pulmonary artery hypertension occurred in 12.1% of patients. Less common findings are summarized in Table 3. All patients underwent surgical correction of CoA by left thoracotomy followed by end-to-end anastomosis. The mean time of surgery and hospitalization was 2.3 hours and 10 days, respectively, and mean cross- clamping time was 15.9 minutes. Of 51 patients operated, Barreto et al. Follow-up of surgically corrected coarctation of the aorta Int J Cardiovasc Sci. 2020;33(1):3-11 Original Article