Coarctation in the first year of life

Waldman, J. Deane; Lamberti, John J.; Goodman, Allan H.; Mathewson, James W.; Kirkpatrick, Stanley E.; Turner, Searle W.; Pappelbaum, Stanley J.

doi:10.1016/s0022-5223(19)39203-7

Cited by 29 publications

(2 citation statements)

References 25 publications

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“…Since the first coarctation of the aorta repair by Crafoord and Gross, 19,20 controversies have remained regarding optimal surgical techniques, in particular, for patients with tubular hypoplasia of the aortic arch. In 1983, Waldman et al 21 stated that the choice of a surgical technique for coarctation of the aorta should be based on the patient's anatomical features rather than the surgeon's preference. Similarly, we believe that the management of coarctation of the aorta should be based on the anatomical features of the aortic arch and the morphology of the isthmic portion.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, when performing coarctation of the aorta surgery, the choice of a surgical technique should be based on the anatomy of the aortic arch instead of the surgeon's preference. 21 Supplementary material. To view supplementary material for this article, please visit https://doi.org/10.1017/S104795112300104X Data availability statement.…”

Section: Study Limitationsmentioning

confidence: 99%

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Outcomes of surgery for coarctation of the aorta based on a new classification system

et al. 2023

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Objectives: To evaluate early- and long-term outcomes of the surgical treatment for coarctation of the aorta based on a new classification system. Methods: A retrospective clinical review of 111 patients with coarctation of the aorta who underwent surgery (March 2011 to August 2020) was performed. We categorised coarctation of the aorta into type I, with all three head vessels tightly packed; type II, with the left subclavian artery separated from the two other head vessels; and type III, with all three head vessels separated from one another. Each type included subtype a, with a short isthmic portion, and subtype b, with a long isthmic portion. Results: The median patient age and weight at operation were 8 (range, 1–1490) days and 3.2 (range, 1.9–18.5) kg, respectively. Extended end-to-end anastomosis was performed via sternotomy in 54, via thoracotomy in 12, end-to-side anastomosis in 31, autologous main pulmonary artery patch augmentation in 12, and modified end-to-end anastomosis combined with subclavian artery flap aortoplasty in two patients. There was one (0.9%) case of early mortality and 12 (10.8%) cases of post-operative complications. Two (1.8%) late deaths occurred during follow-up. Five (4.5%) patients underwent balloon dilatation and three (2.7%) underwent reoperation for restenosis of coarctation of the aorta. All patients with type Ia (21 patients, 18.9%) underwent extended end-to-end anastomosis via sternotomy or thoracotomy. Conclusions: According to the early and late outcomes observed in this study, surgical treatment of coarctation of the aorta using the new classification system could be safe and low risk.

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Section: Discussionmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

Outcomes of surgery for coarctation of the aorta based on a new classification system

et al. 2023

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Complications following reparative surgery for aortic coarctation or interrupted aortic arch

et al. 1998

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Repair of aortic coarctation or interrupted aortic arch continues to be associated with major long-term morbidity. Thus, we conducted a review of 87 consecutive patients who underwent aortic arch repairs, focusing particular attention on the complications that developed. A two-stage strategy was employed if cardiac lesions were associated. The median age at surgery was 1.5 months with a range of 12 h to 56 years. The aortic arch was repaired using end-to-end anastomosis, subclavian flap aortoplasty, subclavian arterial turning-down aortoplasty, patch aortoplasty, tube graft interposition, or other methods. There were 10 patients who died soon after repair, and all of whom had complex cardiac anomalies. Of the remaining 77 patients, 8 developed recurrent stenosis. These 8 patients were all similar in age, being under 3 months old, and weighing 4 kg or less. A multivariable analysis of the infants identified interrupted aortic arch as an independent risk factor for the development of this complication with an odds ratio of 6.45. Complications following prosthesis-free techniques were similar in prevalence and timing. All reinterventions were mortality-free, but catheter dilation and patch aortoplasty were not always successful. Three extraanatomic bypasses were successfully performed, and one adult who had undergone a previous graft and pseudoaneurysm operation was successfully treated with an extraanatomic bypass. These findings led us to conclude that the initial repair should be performed without a prosthesis, and that reintervention for stenosis should combine catheter dilation and extraanatomic bypass.

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Role of extended aortoplasty related to the definition of coarction of the aorta

Amato¹,

Galdieri²,

Cotroneo³

1991

The Annals of Thoracic Surgery

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Coarctation in the first year of life

Cited by 29 publications

References 25 publications

Outcomes of surgery for coarctation of the aorta based on a new classification system

Outcomes of surgery for coarctation of the aorta based on a new classification system

Complications following reparative surgery for aortic coarctation or interrupted aortic arch

Role of extended aortoplasty related to the definition of coarction of the aorta

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