One-stage surgical treatment of 86 cases of aortic coarctation combined with intracardiac malformation
10.3760/cma.j.issn.1001-4497.2019.09.005
- VernacularTitle: 86例主动脉缩窄合并心内畸形患婴的一期手术治疗效果
- Author:
Yuhao WU
1
,
2
;
Yuehang ZHOU
1
,
2
;
Xin JIN
1
,
2
;
Hongyu KUANG
3
,
4
;
Yonggang LI
1
,
2
;
Chun WU
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
2. Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and disorders(Chongqing), Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
3. Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and disorders(Chongqing), Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
4. Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease Coarctation of the aorta Surgery Infants
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(9):526-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics of coarctation of the aorta(CoA) associated with intracardiac anomalies in infants.
Methods:The data from August 2009 to August 2017 of 86 infants who were diagnosed with CoA associated with intracardiac anomalies. Preoperative diagnosis, surgical findings and post-operation follow-up were analyzed retrospectively. There were 56 boys an 30 girls, aqed(95.1±78.0) days, weight(4.6±1.2) kg. Anatomical types included 37 cases of pre-ductal CoA, 44 cases of peri-ducutal CoA, and 5 cases of post-ductal CoA. And this group also included 73 infants complicating VSD, 59 infants complicating ASD, 2 infants complicating DORV, and 1 infant complicating TAPVC.
Results:All of the included patients underwent single-stage repair of CoA associated with intracardiac anomalies. Mean operative time was(279.0±56.4) min, mean cardiopulmonary bypass time was(162.3±51.0) min, and mean aorta cross-clamp time was(74.7±25.2) min. Mean length of ICU stay and ventilation time were(7.4±4.7) days and(101.1±75.4) hours, respectively. The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly [(42.3±17.7) mmHg vs.(22.1±9.4)mmHg, P<0.001], and 7 early deaths were observed after surgery. The mean follow-up time of 79 hospital survivors was(31.0±27.4) months, and no late death was found. Transcoarctation gradient of hospital survivors in the last time follow-up was(21.2±11.0)mmHg. Transcoarctation gradient of 29 cases was higher than 20 mmHg, however, only 4 cases with significant clinical symptom of lower limbs retardation were recommended for ballon angioplasty consultant. The cumulative recoarctation-free survival in 2-year follow-up was 69.2%.
Conclusion:To avoid early second-stage operations, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes of early to mid term follow-up were satisfactory.
