Echocardiographic Follow up after Surgical Correction of Aortic Coarctation during the First Year of Life

The incidence of congenital heart diseases (CHD) is 8–12 per 1000 live born infants (Hofman et al., 2002). Coarctation of the aorta (AoCo), narrowing of the descending aorta usually just distal to the origin of the left subclavian artery, is a relatively common congenital heart disease. It accounts for 6–10% of CHD (Lindinger et al., 2010) with prevalence approximately 3.6 (2.9–4.9)/10.000 newborn infants (Anonymous, 2011b). Surgical correction is the gold standard for the treatment of AoCo in neonates and small infants due to a lower incidence of recoarctation in comparison to balloon angioplasty in this age group. Recurrent AoCo is treated using balloon angioplasty and stent implantation in older children (Walhout et al., 2004; Peres et al., 2010; Fruh et al., 2011). Despite successful surgical correction in infancy, there is a high risk of development of recoarctation (up to 20–40%) and arterial hypertension (7–33%) (Rosenthal, 2005; Hager et al., 2009). Echocardiography in combination with clinical examination is used to evaluate the need for further intervention. The Clinic for Pediatric Cardiology and Cardiac Surgery of the University Hospital for Children in Rîga is the only institution in Latvia where congenital heart diseases are treated and followed up. The beginning of surgical correction of AoCo in Latvia dates back to 1964 (Volkolakov and Lacis, 1987). Balloon angioplasty of Ao recoarctation and primary AoCo in older children was started in January, 2009. We analysed the echocardiographic findings of patients operated on due to AoCo within the first year of life during the years 2000–2010 and who survived up to 31 January 2011, to evaluate the long-term findings in comparison with preoperative data. This is the first echocardiographic study in Latvia that examines findings of patients with AoCo operated on as neonates and small infants.