Post-operative musculoskeletal outcomes in patients with coarctation of the aorta following different surgical approaches

Abstract

Background: The aim of this study was to examine range of motion and muscle function in the upper extremity and spine in patients with coarctation of the aorta (CoA) comparing different surgical approaches.

Methods: From October 2017 to February 2019, 150 patients were assessed for inclusion. A total of 99 patients (n = 75 CoA, n = 24 control), were included and assessed regarding muscle function, arm length and circumference, and spinal and thoracic mobility.

Results: There were significant differences between the right and left arm in patients with CoA, operated with the subclavian flap technique compared to controls in regards to shoulder flexion (p < 0.001), elbow flexion (p = 0.001), shoulder abduction (p = 0.02), handgrip strength (p = 0.01), length of upper arm (p < 0.001), lower arm (p < 0.001), and of whole arm (p < 0.001), circumference regarding upper arm (p = 0.001), lower arm (p < 0.001), and wrist (p < 0.001). Structural scoliosis was more frequent in patients who had undergone thoracotomy (25.4%) than patients who had not undergone a thoracotomy (5.9%, p = 0.04), and were often located in the thoracic part of the spine.

Conclusion: Patients with CoA operated on using the subclavian flap technique have impaired muscle function as well as reduced arm length and circumference. An increased rate of structural scoliosis was found in patients who underwent thoracotomy, in comparison with patients who had not undergone a thoracotomy. Further research is needed to determine whether muscle function impaired by surgical procedures can be improved with exercise.

Keywords: Heart defects, congenital; Muscle strength; Range of motion, articular.