IJCS | Volume 33, Nº1, January / February 2019

10 most likely causes of pulmonary hypertension in these patients, though a role for vascular reactivity has been also proposed. 20 Moreover, BAV was the most common associated malformation in our analysis, which is in agreement with previous studies showing a common genetic mutation for both congenital heart diseases. 21 Noteworthy, it has been proposed that such phenomenon would lead to greater hemodynamic changes, which could plausibly lead to worsen prognosis. 22 In our study, patients with isolated and complex coarctation had comparable results, although larger studies are required to correctly address this issue. Limitations Our study has some limitations that are inherent to retrospective case series. Also, since we collected data from a tertiary care hospital, the possibility of a selection bias cannot be excluded, favoring those with more complex presentations of the disease. Finally, we did not register any hard endpoint, whichweaken the capacity of identifying predictive risk factors for a worse prognosis. Conclusions Coarctectomy improves cardiac symptoms and LV hypertrophy, with a slight effect on the incidence of hypertension. Age at surgical repair and complex malformations were not related to a worse prognosis. In our study, recoarctation had a negative impact on the benefit of surgery in one-third of patients, which reinforces the need for lifelong surveillance by echocardiography. Author contributions Conception and design of the research: Barreto J, Roda J, Germano CW, Quinaglia T. Acquisition of data: Barreto J, Roda J, Germano CW, DamianoAP, Quinaglia T. Analysis and interpretation of the data: Barreto J, Quinaglia T. Statistical analysis: Barreto J, Quinaglia T. Writing of the manuscript: Barreto J, Quinaglia T. Critical revision of themanuscript for intellectual content: Barreto J, Roda J, Germano CW, Damiano AP, Quinaglia T. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associated with any thesis or dissertation work. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 1. Yokoyama U, Ichikawa Y, Minamisawa S, Ishikawa Y. Pathology and molecular mechanisms of coarctation of the aorta and its association with the ductus arteriosus. J Physiol Sci. 2017;67(2):259-70. 2. Lee MG, Allen SL, Kawasaki R, Kotevski A, Koleff J, Kowalski R, et al. High prevalence of hypertension and end-organ damage late after coarctation repair in normal arches.Ann Thorac Surg. 2015;100(2):647-53. 3. Quail MA, Short R, Pandya B, Steeden JA, Khushnood A, Taylor AM, et al. Abnormal wave reflections and left ventricular hypertrophy late after coarctation of the aorta repair. Hypertension. 2017;69(3):501-9. 4. Lombardi KC, Northrup V, McNamara RL, Sugeng L, Weismann CG. Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation. Am J Cardiol. 2013;112(11):1828-33. 5. Brown ML, Burkhart HM, Connolly HM, Dearani JA, Cetta F, Li Z, et al. Coarctation of the aorta: lifelong surveillance is mandatory following surgical repair. J Am Coll Cardiol. 2013;62(11):1020-5. 6. Choudhary P, Canniffe C, Jackson DJ, Tanous D, Walsh K, Celermajer DS. Late outcomes in adults with coarctation of the aorta. Heart. 2015;101(15):1190-5. 7. Farag ES, Kluin J, de Heer F, Ahmed Y, Sojak V, Koolbergen DR, et al. Aortic coarctation repair through left thoracotomy: results in the modern era. Eur J Cardiothorac Surg. 2019;55(2):331-7. 8. Peterson C,Ailes E, Riehle-Colarusso T, Oster ME, Olney RS, Cassell CH, et al. Late detection of critical congenital heart disease among US infants: estimation of the potential impact of proposed universal screening using pulse oximetry. JAMA Pediatr. 2014;168(4):361-70. 9. Canniffe C, Ou P, Walsh K, Bonnet D, Celermajer D. Hypertension after repair of aortic coarctation--a systematic review. Int J Cardiol. 2013;167(6):2456-61. 10. Kenny D, Polson JW, Martin RP, Paton JF, Wolf AR. Hypertension and coarctation of the aorta: an inevitable consequence of developmental pathophysiology. Hypertens Res. 2011;34(5):543-7. 11. Rinnstrom D, Dellborg M, Thilen U, Sörensson P, Nielsen NE, Christersson C, et al. Hypertension in adults with repaired coarctation of the aorta. Am Heart J. 2016 Nov;181:10-5. 12. Khoury PR, Mitsnefes M, Daniels SR, Kimball TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr. 2009;22(6):709-14. References Barreto et al. Follow-up of surgically corrected coarctation of the aorta Int J Cardiovasc Sci. 2020;33(1):3-11 Original Article