Aortic Coarctation Repair Followed by Bentall and Hemiarch Replacement 26 Years Later and Total Arch Replacement 37 Years Later

Abstract

The postoperative course of simple aortic coarctation is favorable, with survival rates at 20, 30, and 40 years of 89%, 82%, and 79%, respectively. However, it is associated with postoperative complications, including postoperative restenosis, aortic aneurysm, aortic dissection, bicuspid aortic valve-associated valve disease, infective endocarditis, coronary artery disease, cerebrovascular accident, and hypertension. This diversity in postoperative complications necessitates long-term follow-up. The patient in the present case underwent aortic coarctation repair through left thoracotomy at another hospital at the age of 9 months. The patient was followed up until 18 years of age but subsequently discontinued follow-up. At age 26 years, the patient was referred to our hospital with a chief complaint of chest pain. Upon examination, we discovered a bicuspid valve-associated aortic insufficiency, an ascending aortic aneurysm, and aortic root dilation. Therefore, we performed Bentall and hemiarch replacement, after which we continued to follow-up the patient at our hospital. At age 37 years, the patient developed an aneurysm in the aortic arch distal to the proximal anastomosis in the initial surgery; therefore, we performed total arch replacement. Despite requiring two surgical interventions after the initial surgery, the patient has demonstrated favorable results. Thus, we report the our findings in this case results here.