| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2005;80:1453-1459
© 2005 The Society of Thoracic Surgeons
a Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan
b Section of Cardiac Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
Accepted for publication April 1, 2005.
* Address reprint requests to Dr Rocchini, C. S. Mott Children's Hospital, University of Michigan Medical Center, Womens L1242, Box 0204, 1500 East Medical Center Dr, Ann Arbor, MI 48109-0204 (Email: rocchini{at}med.umich.edu).
BACKGROUND: The surgical repair of aortic coarctation in infants has evolved over time. This study evaluates our current approach utilizing extended end-to-end anastomosis without prosthetic material to enlarge all areas of aortic arch hypoplasia.
METHODS: The Michigan Congenital Heart Center database was reviewed for infants who underwent repair of isolated aortic coarctation from January 1, 1990, to January 1, 2000.
RESULTS: Eighty-three infants underwent surgical repair of isolated coarctation during this decade. Median age at repair was 21 days (range, 2 to 365). Repair was performed through thoracotomy in 72 patients. Because of severe transverse arch hypoplasia, the remaining 11 infants underwent median sternotomy with circulatory arrest. There were 2 deaths: 1 due to pulmonary hypertension in a patient with alveolar capillary dysplasia and 1 late death due to pneumonia in a patient with noncardiac anomalies. Neither patient had residual coarctation. Technique-related complications of bronchial compression, chylothorax, and vocal cord paralysis were noted in 4 patients. Follow-up data were available for 66 patients (80%) with mean follow-up duration of 4.5 years (SD ± 3.1). Reintervention was required in 4 patients (6%). One underwent reoperation after 1 month, and 3 underwent balloon angioplasty within 7 months of initial repair. The remaining 61 patients are asymptomatic, on no antihypertensive medications, and have aortic arch gradients less than 15 mm Hg. One developed subaortic stenosis necessitating resection.
CONCLUSIONS: Tailored surgical repair for aortic coarctation has a low rate (6%) of residual and recurrent coarctation even when performed in infants. Mortality and morbidity are low.
This article has been cited by other articles:
|
|
 |
|
  S. Tabbutt, S. C. Nicolson, P. C. Adamson, X. Zhang, M. L. Hoffman, W. Wells, C. L. Backer, F. X. McGowan, J. S. Tweddell, P. Bokesch, et al. The safety, efficacy, and pharmacokinetics of esmolol for blood pressure control immediately after repair of coarctation of the aorta in infants and children: a multicenter, double-blind, randomized trial. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 321 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. S. Schoenhoff, P. A. Berdat, M. Pavlovic, A. Kadner, M. Schwerzmann, J.-P. Pfammatter, and T. P. Carrel Off-Pump Extraanatomic Aortic Bypass for the Treatment of Complex Aortic Coarctation and Hypoplastic Aortic Arch Ann. Thorac. Surg., February 1, 2008; 85(2): 460 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Backer Reply Ann. Thorac. Surg., August 1, 2007; 84(2): 715 - 716. [Full Text] [PDF]
|
|
|
|
 |
|
 H.-G. Lim, W.-H. Kim, W.-S. Jang, C. Lim, J. G. Kwak, C. Lee, S. W. Hwang, and C.-H. Lee One-stage total repair of aortic arch anomaly using regional perfusion Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 242 - 248. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
