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
;
Renjie HU
1
;
Wei DONG
1
;
Ying GUO
2
;
Wen ZHANG
1
;
Jie HU
1
;
Yifan ZHU
1
;
Haibo ZHANG
1
Author Information
1. Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P. R. China
2. Department of Cardiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P. R. China
- 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.
