Results of surgical treatment for 79 patients with aortic coarctation combined with complex anomalies: A retrospective analysis in a single center
- VernacularTitle:外科手术治疗主动脉缩窄合并复杂心脏畸形79 例单中心回顾性分析
- Author:
Xiang LIU
1
,
2
;
Huijin WEI
1
,
2
;
Li MA
1
,
2
;
Minghui ZOU
1
,
2
;
Weidan CHEN
1
,
2
;
Xinxin CHEN
1
,
2
Author Information
1. 1. Heart Center, Guangzhou Women and Children'
2. s Medical Center, Guangzhou Medical University, Guangzhou, 510623, P. R. China；2. Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou, 510623, P. R. China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
coarctation of the aorta;
complex cardiac anomalies;
surgical treatment;
outcome
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(11):1466-1471
- CountryChina
- Language:English
-
Abstract:
Objective To summarize the results of surgical treatment for 79 patients with coarctation of the aorta (CoA) combined with complex anomalies (CA) in recent years. Methods The data from 79 patients with CoA combined with CA admitted to Guangzhou Women and Children's Medical Center between January 19, 2010 and September 7, 2017 were collected and analyzed. There were 52 males and 27 females. The median age was 71 days, and the median weight was 4.3 kg. There were 26 patients combined with tracheostenosis and 7 patients with preoperative tracheal intubation. Extended end-to-side anastomosis was used to correct the CoA, and the associated cardiac abnormalities were treated simultaneously by an incision through median sternotomy. All operations were performed by the same group of surgeons. Results The median deep hypothermic circulatory arrest was 18 (13-28) minutes, the median aorta cross-clamp time was 62 (15-199) minutes, the median cardiopulmonary bypass time was 145 (71-674) minutes, the median ventilation time was 72 (9-960) hours, the median length of ICU stay was 144 (12-1 944) hours, and the median length of hospital stay was 24 (2-93) days. Early death occurred in 9 patients and late death occurred in 5 patients. Reoperation occurred in 28 patients and recoarctation developed in 10 patients. After operation, transcoarctation gradient was reduced, and the transcutaneous oxygen saturation, C-reactive protein (CRP), lactate and creatinine were increased. Compared to the survival group, both preoperative and postoperative transcutaneous oxygen saturation were worse and the postoperative levels of plasma brain natriuretic peptide (BNP) and CRP were higher in the death group. Conclusion Correcting the CoA and the associated CA simultaneously with extended end-to-side anastomosis by an incision through median sternotomy is effective and safe, and the outcomes of immediate and medial-term are satisfactory. Improving oxygenation and limiting elevation of BNP and CRP levels may reduce the death rate.
