Objective Patients with previously repaired aortic coarctation (CoA) are at risk of developing late surgical complications. Many patients with CoA also have a bicuspid aortic valve (BAV). We sought to determine in patients with repaired CoA whether the presence of BAV is associated with more cardiovascular reinterventions during follow-up. Methods Adults with previously repaired simple CoA were recruited from our Adult Congenital Heart Disease database (Sydney, Australia). The incidence of complications relating to the ‘CoA-site’ (descending aortic aneurysm or dissection, or recoarctation) and the ‘AV/AscAo’ (aortic valve or ascending aortic pathology) that required intervention was compared between those with BAV (‘CoA-BAV’) and without BAV (‘CoA-only’). Results Of 146 patients with repaired CoA, 101 (69%) had BAV. Age at CoA repair was similar (median 6.0 (IQR 0.5–14.0) years vs 5.0 (IQR 0.5–11.0) years, p=0.44), as was the distribution of repair types, with end-to-end repair the most common in both groups (45.9% vs 45.6%). At a median of 28 years following initial repair, a significantly higher proportion of patients with CoA-BAV required cardiovascular reintervention (45.5% vs 20.0%, p=0.003). Whereas ‘CoA-site’ complications were more common than ‘AV/AscAo’ complications in patients with CoA only (13.3% and 0%, respectively), patients with CoA-BAV had a high prevalence of both ‘CoA-site’ as well as ‘AV/AscAo’ complications (19.8% and 21.8%, respectively). Overall survival was similar (p=0.42). Conclusion In adults with repaired CoA, patients with CoA-BAV are more than twice as likely to require cardiovascular reintervention by early-to-mid-adult life compared with those with CoA alone. Despite this, no difference in survival outcomes was observed. Data are available upon reasonable request.

中文翻译：

---

有或没有二尖瓣主动脉瓣患者主动脉缩窄修复术后的晚期并发症发生率

目的 先前修复过主动脉缩窄 (CoA) 的患者有发生晚期手术并发症的风险。许多 CoA 患者也有二尖瓣主动脉瓣 (BAV)。我们试图在 CoA 修复的患者中确定 BAV 的存在是否与随访期间更多的心血管再干预相关。方法 从我们的成人先天性心脏病数据库（澳大利亚悉尼）中招募具有先前修复过的简单 CoA 的成年人。与 BAV 患者（“CoA- BAV') 和没有 BAV（'仅 CoA'）。结果 146 例 CoA 修复患者中，101 例 (69%) 有 BAV。CoA 修复的年龄相似（中位数 6.0 (IQR 0.5–14.0) 岁 vs 5.0 (IQR 0.5–11.0) 岁，p=0.44），修复类型的分布也相似，其中端到端修复最常见两组（45.9% 对 45.6%）。在初始修复后的中位 28 年，CoA-BAV 患者中需要心血管再干预的比例明显更高（45.5% 对 20.0%，p=0.003）。尽管“CoA 位点”并发症在仅 CoA 患者中比“AV/AscAo”并发症更常见（分别为 13.3% 和 0%），但 CoA-BAV 患者的“CoA 位点”和“CoA 位点”并发症发生率都很高作为“AV/AscAo”并发症（分别为 19.8% 和 21.8%）。总生存期相似 (p=0.42)。结论 在 CoA 修复的成人中，与仅患有 CoA 的患者相比，患有 CoA-BAV 的患者在成年早期至中期需要心血管再干预的可能性是其两倍多。尽管如此，没有观察到生存结果的差异。可根据合理要求提供数据。