ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Andrew C. Fiore
D. Glenn Pennington
Robert G. Johnson
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fiore, A. C.
Right arrow Articles by Johnson, R. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fiore, A. C.
Right arrow Articles by Johnson, R. G.
Related Collections
Right arrow Congenital - acyanotic

Ann Thorac Surg 2005;80:1659-1665
© 2005 The Society of Thoracic Surgeons

Original article: Cardiovascular

Comparison of Angioplasty and Surgery for Neonatal Aortic Coarctation

Andrew C. Fiore, MD a , * , Laurice K. Fischer, MS b , c , d , Theresa Schwartz, MS b , c , d , Saadeh Jureidini, MD b , c , d , Ian Balfour, MD b , c , d , Dustin Carpenter, BA b , c , d , Daphne Demello, MD b , c , d , Katherine S. Virgo, PhD b , c , d , D. Glenn Pennington, MD b , c , d , Robert G. Johnson, MD b , c , d

a Division of Cardiovascular Surgery, St. Louis University School of Medicine/Cardinal Glennon Children's Hospital, St. Louis, Missouri
b Division of Pediatric Cardiology, St. Louis University School of Medicine/Cardinal Glennon Children's Hospital, St. Louis, Missouri
c Division of Pediatric Pathology, St. Louis University School of Medicine/Cardinal Glennon Children's Hospital, St. Louis, Missouri
d Division of Cardiothoracic Surgery, East Tennessee State University, Johnson City, Tennessee

Accepted for publication March 21, 2005.

* Address correspondence to Dr Fiore, St. Louis University Health Sciences Center, Cardinal Glennon Children's Hospital, 1465 S. Grand Blvd, St. Louis, MO 63104 (Email: fiorem2{at}slu.edu).

Presented at the Fifty-first Annual Meeting of the Southern Thoracic Surgical Association, Cancun, Mexico, Nov 2–4, 2004.

BACKGROUND: The efficacy of balloon dilatation as primary treatment for neonatal aortic coarctation remains controversial.

METHODS: A retrospective comparison between balloon angioplasty and surgery for the treatment of neonatal aortic coarctation was undertaken on 57 neonates younger than 40 days of age (angioplasty, 23 patients; surgery, 34 patients) treated between 1994 and 2004.

RESULTS: Cohorts were similar with respect to the preinterventional variables of age, weight, upper extremity systolic blood pressure, coarctation gradient, degree of aortic arch hypoplasia, associated conditions, and mean follow-up (angioplasty, 36 months; surgery, 38 months). Among the angioplasty group, 13 patients (57%) required surgery, and 8 required a second balloon dilatation, of whom 3 patients had an aortic aneurysm. Among the surgery cohort, 6 patients experienced recurrence (18%) after either SFA (3) or XETE anastomosis repair (3). All were successfully treated with balloon angioplasty. Actuarial freedom from any intervention was significantly greater in the surgery cohort as was the degree of aortic arch growth. At latest follow-up, antihypertensive medication was required in 3 of 9 angioplasty patients (33%) and 2 of 27 surgery patients (7%). No repeat intervention was required in the 13 patients who underwent angioplasty followed by surgery.

CONCLUSIONS: Primary angioplasty is palliative treatment for neonatal aortic coarctation, but it is the treatment of choice for recurrence after surgery. Surgery for neonatal aortic coarctation is associated with fewer reinterventions, improved aortic arch growth, no aortic aneurysm formation, and decreased need for antihypertensive medication when compared with neonates treated primarily with balloon angioplasty.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
J. W. Brown, M. Ruzmetov, M. H. Hoyer, M. D. Rodefeld, and M. W. Turrentine
Recurrent Coarctation: Is Surgical Repair of Recurrent Coarctation of the Aorta Safe and Effective?
Ann. Thorac. Surg., December 1, 2009; 88(6): 1923 - 1931.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
L. Botta, V. Russo, G. Oppido, M. Rosati, F. Massi, L. Lovato, R. Di Bartolomeo, and R. Fattori
Role of endovascular repair in the management of late pseudo-aneurysms following open surgery for aortic coarctation
Eur. J. Cardiothorac. Surg., October 1, 2009; 36(4): 670 - 674.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. T. Burch, C. G. Cowley, R. Holubkov, D. Null, L. M. Lambert, P. C. Kouretas, and J. A. Hawkins
Coarctation repair in neonates and young infants: Is small size or low weight still a risk factor?
J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 547 - 552.
[Abstract] [Full Text] [PDF]

Home page
 MMCTSHome page
G. Gargiulo, C. P. Napoleone, E. Angeli, and G. Oppido
Neonatal coarctation repair using extended end-to-end anastomosis
MMCTS, May 23, 2008; 2008(0523): 2691.
[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
Copyright © 2005 by The Society of Thoracic Surgeons.