Outcomes of arch reintervention for post-repair recoarctation: A retrospectivel analysis in a single center
- VernacularTitle:儿童主动脉缩窄术后再缩窄内外科治疗的单中心回顾性分析
- Author:
Qi JIANG
1
,
2
;
Renjie HU
1
,
2
;
Wei DONG
1
,
2
;
Ying GUO
2
,
3
;
Wen ZHANG
1
,
2
;
Jie HU
1
,
2
;
Yifan ZHU
1
,
2
;
Haibo ZHANG
1
,
2
Author Information
1. Department of Cardiovascular and Thoracic Surgery, Shanghai Children'
2. s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P. R. China
3. Department of Cardiology, Shanghai Children'
- Publication Type:Journal Article
- Keywords:
Aortic coarctation;
recoarctation;
congenital heart disease;
balloon angioplasty;
reoperation;
restenosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(11):1472-1477
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss outcomes of arch reintervention for post-repair recoarctation in children. Methods From 2009 to 2019, 48 patients underwent reintervention for post-repair recoarctation in Shanghai Children’s Medical Center. Of the 48 patients, 22 patients had surgical repair, 25 patients had balloon angioplasty (BA), and 1 patient had a stent implantation. The clinical data were analyzed, and the difference in time-to-event distribution between the surgical group and the BA group was determined by a log-rank test. Results The median age at reintervention was 15.0 months (range, 3.0 months-15.1 years). The median weight at reintervention was 9.8 kg (range, 3.0-58.0 kg). The time to reintervention after initial repair was 12.5 months (range, 2.0 months-7.8 years). One patient (2.1%) died in hospital and 1 patient (2.1%) experienced arrhythmia after surgical repair. One late mortality (2.1%) occurred after surgical reintervention. One patient (2.1%) experienced aortic dissection after BA. No patient died after BA. Freedom from residual coarctation or new recurrences was 66.7%, 61.3%, and 56.9%, respectively, at 1, 2, and 5 years after reintervention. Freedom from residual coarctation or new recurrences was 90.0%, 81.8%, and 70.1%, respectively, at 1, 2, and 5 years after surgical repair. Freedom from residual coarctation or new recurrences was 52.0%, 48.0%, and 48.0%, respectively, at 1, 2, and 5 years after BA. Compared with BA, surgery-based reintervention had a lower incidence of residual coarctation or recurrences (χ2=4.400, P=0.036). Conclusion Reintervention for recoarctation has favorable early outcomes. Compared with balloon angioplasty, surgical repair has a more lasting effect in relieving the recoarctation.
