Contemporary outcomes of childhood aortic coarctation interventions: a national registry analysis of mortality, reinterventions and hospital resource use
Authors' conclusion
Subgroups of patients with CoA are still at risk of unfavourable outcomes during childhood and adolescence follow-up, especially cardiac reintervention at a distance from initial repair. Hospital resource utilisation remains low beyond the first year of life in the majority of patients. Identified factors, while non-modifiable, remain useful in risk stratification and counselling.
Study context
- Population
- Patients with coarctation of the aorta (CoA) treated between 2000 and 2017 in England and Walespatients included · CoA with ventricular septal defect (VSD) 669 · CoA with small VSD 331 · isolated CoA 2,321
- Participants
- 3,321 patients
- Exposure
- CoA with ventricular septal defect (VSD) vs CoA with small VSD vs isolated CoA vs isolated surgical repair vs isolated catheter repair vs concomitant VSD closure vs pulmonary artery banding
- CoA with ventricular septal defect (VSD)n = 669
- CoA with small VSDn = 331
- Isolated CoAn = 2,321
- Outcome
- Mortality (from birth)
- Follow-up
- 10 years
Methodological detailsmulticentre, longitudinal, linked hospital and outpatient records (LAUNCHES)
- Multicentre
- Longitudinal
- Linked hospital and outpatient records (LAUNCHES)
Main finding
As reported in the abstract
Mortality
3.7%
95% CI 3.0%; 4.4%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Risk of reintervention by repair typeIsolated catheter repair vs isolated surgical repair · higher risk of reintervention | 3.7 (2.2–6) | |
| Risk of reintervention by repair typeConcomitant VSD closure vs isolated surgical repair · higher risk of reintervention | 1.34 (1–1.9) | |
| Risk of reintervention by repair typePulmonary artery banding vs isolated surgical repair · higher risk of reintervention | 3.5 (2.4–5.1) | |
| 0.20.5125Hazard ratio (log scale) |
Cardiac reintervention (from CoA repair) · 10 years
- Cardiac reintervention
- 13.3% (12.1%; 14.5%)
Time in hospital · first year of life; beyond 8 years
- Median time in hospital, first year of life
- 26 days (IQR 17; 44)
- Beyond 8 years
- 1 (0; 2) day
Factors associated with fewer days spent at home
- CoA with large VSD
- −12, (−16; −8)
- Premature birth
- −50, (−60; −40)
- Congenital comorbidity
- −31, (−37; −25)
- Low weight
- −23/kg, (−37; −11)
- Younger age at first procedure
- −6/year (−7; −5)
- Quantile regression at median
Original publication
Contemporary outcomes of childhood aortic coarctation interventions: a national registry analysis of mortality, reinterventions and hospital resource use. Heart. Published 8 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it