Mechanical cause for acute left lung atelectasis after neonatal aortic arch repair with arterial switch operation: Conservative management

Maddali, Madan Mohan; Kandachar, Pranav Subbaraya; Al-Hanshi, Said; Ghafri, Mohammed Al; Valliattu, John

doi:10.4103/aca.aca_197_16

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…If on the one hand the diagnosis of airway compression can be easily performed, the therapeutic handling can be challenging, especially in cases of severe residual malacia. The choice between a surgical option, such as posterior aortopexy, the remodeling of the aortic arch, and transverse extension of the aortic arch using an autograft of the pulmonary artery, as compared to a conservative conduct, 1,6 should be based on the severity of the obstruction and the clinical condition of the patient. 2,5 The tracheostomy with prolonged mechanical ventilation has been proposed when one considers the tracheomalacia to be self-limited, with progressive improvement during childhood.…”

Section: Discussionmentioning

confidence: 99%

Expandable Airway Stents: Success in the Extrinsic Bronchial Compression Approach After Reconstruction of the Aortic Arch

Silva¹,

Guimarães²,

Wang³

et al. 2023

ABC Imagem Cardiovascular

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Section: Discussionmentioning

confidence: 99%

Expandable Airway Stents: Success in the Extrinsic Bronchial Compression Approach After Reconstruction of the Aortic Arch

Silva¹,

Guimarães²,

Wang³

et al. 2023

ABC Imagem Cardiovascular

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“…Se por um lado o diagnóstico da compressão das vias aéreas pode ser facilmente realizado, o manejo terapêutico pode ser desafiador, especialmente nos casos de grave malácia residual. A escolha entre uma opção cirúrgica, como aortopexia posterior, remodelação do arco aórtico e extensão transversa do arco aórtico usando autoenxerto da artéria pulmonar, e uma conduta conservadora, 1,6 deve ser baseada na gravidade da obstrução e na condição clínica do paciente. 2,5 A traqueostomia com ventilação mecânica prolongada tem sido proposta ao considerar a traqueomalácia autolimitada, com melhora progressiva durante a infância.…”

Section: Silva Et Al Stent Expansível Em Compressão Brônquica Extrínsecaunclassified

Stent Expansível em Via Aérea: Sucesso na Abordagem de Compressão Brônquica Extrínseca Após Reconstrução do Arco Aórtico

Silva

Guimarães

Wang

et al. 2023

Arq Bras Cardiol: Imagem cardiovasc.

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A interrupção do arco aórtico é uma cardiopatia congênita rara, cuja correção cirúrgica geralmente requer reconstrução do arco aórtico. Essa intervenção pode causar distorção do espaço aortopulmonar e resultar em compressão brônquica com consequente atelectasia pulmonar e dependência de assistência ventilatória. As opções terapêuticas mais utilizadas para descompressão brônquica nem sempre são suficientes para possibilitar expansão pulmonar. Relatamos um caso de implante de stent brônquico endoluminal em um lactente que, no pós-operatório de correção de interrupção do arco aórtico, desenvolveu atelectasia total do pulmão esquerdo secundária a compressão brônquica, sem resposta após aortopexia posterior.

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“…У літературних джерелах відзначена роль залишкового градієнта, форми дуги аорти, методики пластики в розвитку післяопераційної гіпертензії [5]. Можливим ускладненням хірургічного лікування гіпоплазії дуги аорти в неонатальному періоді є здавлення трахеобронхіального дерева [6,7]. Ускладнення післяопераційного періоду спостереження суттєво впливають на результати лікування та якість життя пацієнтів, а тому потребують ретельної уваги в плані раннього виявлення і своєчасного лікування.…”

Section: український журнал серцево-судинної хірургії 2021 4 (45)unclassified

Complications of Surgical Treatment of Aortic Arch Hypoplasia in Infants

Truba

Dziuryi

Sekelyk³

et al. 2021

ujcvs

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Aortic arch surgery in neonatal patients remains problematic despite the constant evolution and improvement of treatment methods. Even after successful correction, complications associated with aortic arch reconstruction are more common in young children. This is especially true for newborns and infants with concomitant complex congenital intracardiac abnormalities. Despite the risk of postoperative complications, the risk of surgical treatment of aortic arch hypoplasia is lower than the cumulative hazards associated with the natural course of this defect. That is why pediatric cardiologists are obliged to constantly monitor the operated patients in order to timely identify and treat complications. The aim. To analyze the complications in the early and remote postoperative periods after the reconstruction of the aortic arch in the neonatal period. Materials and methods. The work is based on a study of 445 patients under 1 year of age, who underwent surgical treatment of aortic arch hypoplasia from 2010 to 2019. The criterion for inclusion in the study group was the presence of isolated hypoplasia of the aortic arch and combination with other defects, which were corrected by two-ventricular repair. The majority of the treated patients were male (284 [63.8% of the total number of patients]). The median age of the patients was 0.7 months (0.3; 2.7). The median body weight of the patients was 3.7 kg (3.25; 4.59). Results. At the hospital stage, 12 patients died, which accounted for 3.1% of the entire cohort of operated patients. Complications occurring at the hospital stage were recorded in 75 (16.8%) patients. In the long term, a complicated course was observed in 72 (16.6%) children. Among them, the most frequent complications were: respiratory failure requiring prolonged mechanical ventilation (36.9%), dilated sternum due to severe heart failure (17.4%), diaphragmatic paresis (8.7%), chylothorax (5.4%). In the long term, 47 (10.5%) patients developed aortic arch restenosis, which required reinterventions. The proportion of patients without reoperations in the follow-up period according to the KaplanMeier analysis was 93.4% after 1 year, 91.2% after 4 years, and 76.5% after 9 years. Residual hypertension requiring medical treatment was reported in 59 (13.2%) patients. Conclusions. Aortic arch hypoplasia is a complex congenital heart disease; its surgical treatment is accompanied by the development of complications both in the early and in the long-term period. The main complications at the hospital stage were respiratory and heart failures which were associated with the presence and correction of concomitant congenital heart defects. The main complication of the follow-up period was reobstruction at the level of the aortic arch. Anatomical correction of reobstruction is safe with both endovascular and surgical treatments.

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Mechanical cause for acute left lung atelectasis after neonatal aortic arch repair with arterial switch operation: Conservative management

Cited by 5 publications

References 10 publications

Expandable Airway Stents: Success in the Extrinsic Bronchial Compression Approach After Reconstruction of the Aortic Arch

Expandable Airway Stents: Success in the Extrinsic Bronchial Compression Approach After Reconstruction of the Aortic Arch

Stent Expansível em Via Aérea: Sucesso na Abordagem de Compressão Brônquica Extrínseca Após Reconstrução do Arco Aórtico

Complications of Surgical Treatment of Aortic Arch Hypoplasia in Infants

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