Surgical treatment of aortic coarctation within the first year of life: a 10 year review (clinical, surgical, biomechanical aspects)

Elīna Teivane, Aris Lacis, Valts Ozolins, Lauris Smits, Normunds Sikora, Inta Bergmane

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Introduction: We analyzed a single institution 10-year experience with coarctation repair within the first year of life to define risk factors for recoarctation, evaluate morbidity, mortality, short and long term results.
Materials and methods: Retrospective and prospective study/ follow-up of all (71) patients younger than 12 months undergone aortic coarctation repair in our institution between January 1,2000 and December 31, 2009.
Results: The patients were 42 boys and 29 girls divided into two groups according the age at the time of repair: neonates 38 (53%)(mean age 11.6 (2–30 days)), infants  33 (47%) (mean age 2.9 months). The mean weight at surgery for neonates was 3.3 kg . Patients were dividend into three groups: group I- simple
coarctation (neonates n 16, infants n  24), group II -coarctation and VSD (neonates n  11,infants n 3), group III-different complex intracardiac lesions(neonates n 11, infants n 6). Infantile coarctation was present in 46 cases (65%), hypoplastic arch in 11 cases. Techniques for primary repair included resection with extended end-to-end anastomosis in neonatal group n 4/older babies n 3, subclavian flap aortoplasty (SFA) n 29 neonates/n 18 babies, resection with simple end-to-end anastomosis (ETE) n 4 neonates/ n 12 infants.
Early mortality n 4 (5.6%) (neonates), late mortality n 9 (12.7%) (neonates). Slight shortening of the left arm found in 3 patients, asymmetry of palms in one patient in the group of Waldhausen‘s operation (8.5%). No paraplegia occurred. Study includes follow-up data from 63 patients (mean follow up 4.3 years (range 0–9 years)).
Recoarctation occurred at the age 2 months–7 years in 12 from 67 patients (17.9%) (Early death patients excluded), mostfrequent with ETE and SFA repairs (4/8 cases respectively). Patients required balloon angioplasty and all except one have no significant residual gradient. There was no mortality or complications after reinterventions.
Conclusions: Infantile aortic coarctation in neonatal age is a significant problem and carries high mortality and recoarctation rate. Baloon angioplasty of recoarctation is safe and effective. Mortality is most importantly influenced by preoperative status, the severity of the associated anomalies, perioperative intensive treatment. There were no severe ischemic complications of the
left arm connected with subclavian flap aortoplasty
Original languageEnglish
Pages (from-to)S71-S71
Number of pages1
JournalCardiology in the Young
Volume20
Issue number2
DOIs
Publication statusPublished - 26 May 2010
Externally publishedYes
Event44th Annual Meeting of the Association for European Paediatric Cardiology,
AEPC with joint sessions with the Japanese Society of Pediatric Cardiology and
Cardiac Surgery Innsbruck, Austria May 26–29, 2010
- Insbruck, Insbruck, Austria
Duration: 26 May 201029 May 2010
Conference number: 44

Field of Science*

  • 3.2 Clinical medicine
  • 2.6 Medical engineering
  • 3.4 Medical biotechnology

Publication Type*

  • 3.3. Publications in conference proceedings indexed in Web of Science and/or Scopus database

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