Surgical outcomes of interrupted aortic arch with ventricular septal defect in neonates and infants
10.3760/cma.j.cn112434-20200428-00229
- VernacularTitle:新生儿及婴儿期主动脉弓中断合并室间隔缺损的手术疗效分析
- Author:
Wen ZHANG
1
;
Qi JIANG
;
Yifan ZHU
;
Renjie HU
;
Xiafeng YU
;
Wei DONG
;
Hongbin ZHU
;
Haibo ZHANG
Author Information
1. 上海交通大学医学院附属上海儿童医学中心心胸外科 200127
- Keywords:
Interrupted aortic arch;
Ventricular septal defect;
Aortic arch obstruction;
Left ventricular outflow tract obstruction;
Reoperation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(6):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the surgical outcomes of interrupted aortic arch with ventricular septal defect (IAA/VSD) in neonates and infants.Methods:This was a retrospective review of clinical data of 123 neonates and infants who received surgery for IAA/VSD from Jan 2009 to Jan 2019. Median age at repair was 48 days. Forty-four patients (36%) were neonates. One-hundred-and-twenty-two patients (99%) underwent standard aortic arch reconstruction with VSD closure, and one neonate (1%) underwent staged Yasui operation. Risk factors for early mortality was analyzed by decision tree model.Results:Early mortality after surgery was 13%. Duration of cardiopulmonary bypass longer than 135 min, surgery received during neonatal period and before 2016 was identified as higher risk group for mortality. Median follow-up time was 3.5 years (range, 1-10 years). Freedom from aortic arch obstruction at 6 months, 1 year, 5 years after surgery was 75%, 72% and 72% respectively. Freedom from left ventricular outflow tract (LVOT) obstruction at 6 months, 1 year, 5 years after surgery was 91%, 83% and 73% respectively. A total of 17 patients received 21 reoperations. The patient who received Yasui operation experienced no residual obstruction during the follow-up.Conclusion:Early outcomes after surgery for IAA/VSD in neonates and infants are satisfactory. However, patients with standard aortic arch reconstruction have a higher risk for aortic and LVOT obstruction, and require multiple reoperations.
