This survey includes a question that asks whether a diagnosis of high blood pressure was present, as well as inquiring regarding current medications and any cardiac catheterization procedures or surgical procedures performed. In patients in whom an intervention is reported, medical records are requested from outside institutions in an?attempt to confirm the procedure indication and type. The presence of hypertension was determined through repeated elevated blood pressure measurements using standard definitions of hypertension (adults: systolic blood pressure?��140 mm Hg and diastolic blood pressure?��140 mm Hg) (7) and for children as systolic and/or diastolic blood pressure in the?��95th percentile (8), the prescription or report of antihypertensive medications, or the self-report of a diagnosis of hypertension. Statistical analyses were performed using SAS version 9.1 (SAS Institute Inc, Cary, Staurosporine
North Carolina). Data are presented as mean �� SD, median (range), or number (%), as appropriate. Univariate and stepwise multivariate models were created http://www.selleckchem.com/
using Cox proportional hazards. Kaplan-Meier curves were compared using a log-rank test. Cutoff values were identified using an SAS macro designed to find the best cutoff point of a continuous variable based on a chi-square statistic for a binomial outcome. Pre-operative characteristics are listed in Table?1. Operations included end-to-end anastomosis in 631 patients, patch angioplasty in 73, interposition graft in 49, bypass graft in 30, and subclavian flap or other in 36. These operations were predominantly performed prior to the 1980s (n?= 612; 74.7%). The type of repair has changed over the decades, with older patients and more complex repairs predominating in later decades (Fig.?1). Overall early mortality (<30 days) was 2.4%. In the previous 30 years (n?= 225), there were no operative deaths. Mean follow-up was 17.4 �� 13.9 years, with a maximum of 59.3 years. Four hundred fifty-nine patients had follow-up >30 days, and an additional 122 surveys were returned. Thus, data on mid- or late-term follow-up was obtained from 70.8% of all patients. Actuarial survival rates were 93.3%, Selleckchem EPZ5676
86.4%, and 73.5% at 10, 20, and 30 years, respectively. Mean age of death was 34.2 �� 20.1 years. When compared to an age- and sex-matched population, long-term survival was decreased (p?< 0.001) (Fig.?2). Older age at repair (>20 years) and pre-operative hypertension were associated with decreased survival (p?< 0.001). On multivariate analysis, only increasing age was associated with mortality (hazard ratio [HR]: 1.06; 95% CI: 1.04 to 1.07; p?< 0.001) (Fig.?3). Rates of freedom from re-intervention on the descending aorta were 96.7%, 92.2%, and 89.4% at 10, 20, and 30 years, respectively (Fig.?4). Older age (HR: 0.93; 95% CI: 0.91 to 0.96; p?< 0.001) and an end-to-end anastomosis technique (HR: 0.11; 95% CI: 0.07 to 20; p?< 0.001) were independently associated with lower re-intervention rates on the descending aorta.