Do High-Risk Infants Have a Poorer Outcome From Primary Repair of Coarctation? Analysis of 192 Infants Over 20 Years

McGuinness, Jonathan; Elhassan, Yahya; Lee, Sim Yee; Nölke, Lars; Oslizlok, Paul; Walsh, Kevin; Redmond, John M.; Wood, A. E.

doi:10.1016/j.athoracsur.2010.06.130

Cited by 18 publications

(15 citation statements)

References 12 publications

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“…It is believable that a VSD adds to the risk and that other major cardiac defects create an even higher-risk population. Although there are individual reports that suggest high risk patients can receive coarctation or arch repair with limited risk, 8,23,26 the numbers of patients in this review provide enough “power ” to validate that while the risk of some additional lesions (even a VSD) may be small, they still create a significant effect on outcome. We would conclude that risk is individual, but can be increased by small size, 28 the presence of a VSD, and other cardiac lesions (especially if they are outside the spectrum of Shone’s syndrome, or LHAC).…”

Section: Discussionmentioning

confidence: 91%

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Contemporary patterns of surgery and outcomes for aortic coarctation: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Ungerleider

Pasquali

Welke

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Objective The objective of this study was to describe characteristics and early outcomes across a large multicenter cohort undergoing coarctation or hypoplastic aortic arch repair. Methods Patients undergoing coarctation or hypoplastic aortic arch repair (2006–2010) as their first cardiovascular operation in the Society of Thoracic Surgeons Congenital Heart Surgery Database were included. Group 1 patients consisted of those with coarctation or hypoplastic aortic arch without ventricular septal defect (coarctation or hypoplastic aortic arch, isolated); group 2, coarctation or hypoplastic aortic arch with ventricular septal defect (coarctation or hypoplastic aortic arch, ventricular septal defect); and group 3, coarctation or hypoplastic aortic arch with other major cardiac diagnoses (coarctation or hypoplastic aortic arch, other). Results The cohort included 5025 patients (95 centers): group 1, 2705 (54%); group 2, 840 (17%); and group 3, 1480 (29%). Group 1 underwent coarctation or hypoplastic aortic arch repair at an older age than groups 2 and 3 (groups 1, 2, and 3, 75%, 99%, and 88% < 1 year old, respectively; P<.0001). The most common operative techniques for coarctation or hypoplastic aortic arch repair (group 1) were end-to-end (33%) or extended end-to-end (56%) anastomosis. Overall mortality was 2.4%, and was 1%, 2.5%, and 4.8% for groups 1, 2, and 3 respectively (P < .0001). Ventricular septal defect management strategies for group 2 patients included ventricular septal defect closure (n = 211, 25%), pulmonary artery band (n = 89, 11%), or no intervention (n = 540, 64%) without significant difference in mortality (4%, 1%, 2%; P = .15). Postoperative complications occurred in 36% of patients overall and were more common in groups 2 and 3. There were no occurrences of spinal cord injury (0/973). Conclusions In the current era, primary coarctation or hypoplastic aortic arch repair is performed predominantly in neonates and infants. Overall mortality is low, although those with concomitant defects are at risk for higher morbidity and mortality. The risk of spinal cord injury is lower than previously reported.

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Section: Discussionmentioning

confidence: 91%

“…8,20–26 Two multi-institutional reviews have appeared in the cardiac surgery literature during the past 18 years. In 1994, a Congenital Heart Surgeon’s Society multi-institutional study was reported by Quaegebeur and colleagues.…”

Section: Discussionmentioning

confidence: 99%

Contemporary patterns of surgery and outcomes for aortic coarctation: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Ungerleider

Pasquali

Welke

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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“…Furthermore, there was a lower complication rate with stent placement compared to BA alone. As such, the current trend seems to be shifting toward primary stent placement in older children and adults while surgery remains favored in young children . BA as a bridge to stent therapy may be an effective alternative to surgery for young children who are too small to initially accommodate a stent that can be serially dilated to adult size.…”

Section: Discussionmentioning

confidence: 99%

A prospective observational multicenter study of balloon angioplasty for the treatment of native and recurrent coarctation of the aorta

Harris

Cowley

et al. 2013

Cathet Cardio Intervent

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“…Furthermore, there was a lower complication rate with stent placement compared to BA alone. As such, the current trend seems to be shifting toward primary stent placement in older children and adults while surgery remains favored in young children [18,19]. BA as a bridge to stent therapy may be an effective alternative to surgery for young children who are too small to initially accommodate a stent that can be serially dilated to adult size.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Multicenter Study of Balloon Angioplasty for the Treatment of Native and Recurrent Coarctation of the Aorta

Harris¹,

Du²,

Cowley³

et al. 2013

Canadian Journal of Cardiology

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Do High-Risk Infants Have a Poorer Outcome From Primary Repair of Coarctation? Analysis of 192 Infants Over 20 Years

Cited by 18 publications

References 12 publications

Contemporary patterns of surgery and outcomes for aortic coarctation: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Contemporary patterns of surgery and outcomes for aortic coarctation: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

A prospective observational multicenter study of balloon angioplasty for the treatment of native and recurrent coarctation of the aorta

A Prospective Multicenter Study of Balloon Angioplasty for the Treatment of Native and Recurrent Coarctation of the Aorta

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