Strategy of repairing coarctation of aorta with hypoplastic aortic arch using cardiopulmonary bypass in neonates
10.3760/cma.j.issn.1001-4497.2018.07.006
- VernacularTitle:体外循环下新生儿主动脉缩窄合并主动脉弓发育不良矫治的策略分析
- Author:
Le PENG
1
;
Xiaodong ZHOU
;
Qing ZHANG
;
Baoying MENG
;
Yuanxiang WANG
;
Yunxing TI
;
Yiqun DING
Author Information
1. 518038,深圳市儿童医院心脏外科
- Keywords:
Coarctation of aorta;
Cardiopulmonary bypass;
Hypoplastic aortic arch;
Neonate
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(7):406-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analysis the the strategy of repairing coarctation of aorta with hypoplastic aortic arch in neo-nate.Methods Collected consecutive 24 neonates suffered coarctation of aorta with hypoplastic aortic arch form January 2015 to March 2017,12 patients were underwent aortic arch reconstruction with extremely extended end-to-end anastomosis under cardiopulmonary bypass(CPB) through the media sternotomy approach(CPB group), while another 12 cases were under coarc-tation repair using end-to-end anastomosis or end-to-side anastomosis through left posterolateral thoracotomy approach ( control group).The postoperative blood pressure,echocardiography and cardiac CT scan were used to evaluate the result of the aortic arch rconstruction.The pressuregradientof the upper limb and lower limb,flow velocity of the anastomoses, aortic arch morphol-ogy,rate of the residual abstruction were compared between the two groups.Results Mechanical ventilation time[ CPB group (17 ±27)h vs.control group(44 ±52)h, P＜0.05], ength of stay in ICU[CPB group(3.75 ±1.36)days vs.control group (6.54 ±5.08)days, P＜0.05], all patients were followed up for 1－12 months,the aortic residual pressure[CPB group(14 ± 10)mmHg (1 mmHg＝0.133 kPa) vs.control group(26 ±17)mmHg,P ＜0.05) ], flow velocity of the anastomoses[CPB group(2.32 ±0.78)m/s, control group(1.55 ±0.99)m/s, P ＜0.05 ], pressuregradientof the upper limb and lower limb [CPB group (6.67 ±3.49)mmHg, control group(7.41 ±4.29)mmHg, P＞0.05].There was no died in two gruops.Con-clusion Anastomosis with end to end techinique under cardiopulmonary bypass may achieve better effect in neonates with co-arctation of aorta with hypoplastic aortic arch,it has better duplcity, operability and early curative effect,but the long-term effect need the multicenter and large sample-volume study to explore.
