Results of repair of coarctation of the aorta during infancy
129
Citation
32
Reference
10
Related Paper
Citation Trend
Cite
Citations (30)
The proper management of coarctation in infancy is still poorly defined. Frequently, the high mortality rate in this age group has been attributed solely to the complex intracardiac lesions associated with coarctation and a rather defeatist attitude has been adopted with regard to treatment. Seventy-three patients under 2 years of age with coarctation of the aorta were reviewed. Congestive heart failure was present in 88%. The patients were divided into three groups: (1) Coarctation with or without patent ductus. There were 34 patients. Twenty-one were treated medically and there was a mortality rate of 71%. Thirteen were treated surgically and there was a mortality rate of 15%. (2) Coarctation with or without a patent ductus and an associated potentially correctable intracardiac defect. Fourteen were treated nonsurgically and all died. The remainder were treated by operation and 45% survived. (3) Coarctation and associated complex intracardiac malformations. All died. This review indicates that the high mortality rate of symptomatic coarctation of the aorta in infancy is significantly decreased by early operation.
Ductus arteriosus
Cite
Citations (37)
Cite
Citations (9)
Ductus arteriosus
Cite
Citations (1)
Cite
Citations (0)
Median sternotomy
Thoracotomy
Cite
Citations (0)
A two stage surgical approach is usually prepared for symptomatic babies affected by coarctation of aorta associated with intracardiac defects, the preliminary operation being the resection of the coarctation. One stage correction has been attempted in six patients, ranging from 2 to 24 m. of age and from 3,2 to 9,7 Kg. of weight. The associated lesions were a large V.S.D. (3 patients), a V.S.D. with pulmonary stenosis, a mitral stenosis and a mitral insufficiency. The coarctation was approached through a left thoracotomy and the intracardiac defect through a midline sternotomy incision, after the patient was turned around. All patients survived and did well following the double procedure. The two-stage surgical approach is unnecessary and probably unadvisable for patients with coarctation of the aorta and associated intracardiac lesions.
Thoracotomy
Median sternotomy
Cite
Citations (22)
Ductus arteriosus
Cite
Citations (1)
Introduction This study aims to summarize the clinical characteristics of coarctation of the aorta (CoA) associated with intracardiac anomalies in infants. Methods Medical records of 93 infants who were diagnosed with CoA and intracardiac anomalies from August 2009 to August 2018 were retrospectively reviewed. Results All of the 93 infants underwent single-stage repair for CoA associated with intracardiac anomalies. Mean operative time was 264.6±57.1 minutes, and the time of ICU stay was 7.0±4.1 days. The residual transcoarctation pressure gradient before discharge was lower than the pressure gradient prior to surgery (48.3±17.5 vs 22.4±9.6mmHg, P<0.01). Early death before discharge was found in 5 infants. The mean follow-up time of 88 hospital survivors was 40.0±26.4 months, and no subsequent death occurred in the follow-up. Transcoarctation pressure gradient of 88 survivors in their last follow-up was 19.6±10.5mmHg. Pressure gradient of 27 cases was higher than 20 mmHg. Significant lower limbs retardation was observed in 4 cases, therefore, balloon angioplasty consult was recommended. The cumulative recoarctation-free survival rate in 3-year follow-up was 73.5%. Conclusions To avoid secondary operations in early period, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes in early to mid-term follow-up were satisfactory.
Single Center
Medical record
Cite
Citations (10)