Repair of Coarctation of the Aorta in Neonates and Infants: A Thirty-Year Experience

Zehr, Kenton J.; Gillinov, A. Marc; Redmond, John M.; Greene, Peter S.; Kan, Jean S.; Gardner, Timothy J.; Reitz, Bruce A.; Cameron, Duke E.

doi:10.1016/0003-4975(94)00825-r

Cited by 71 publications

(61 citation statements)

References 32 publications

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“…This prevalence of systolic hypertension is in agreement with the 10-50% hypertension statistics generally reported in long-term follow-up of patients operated on for coarctation of the aorta, but which also includes patients with recoarctation or associated cardiac and non-cardiac anomalies [15,17,18,24] . In the present study, patients were selected if they were free of restenosis and led a normal active life, which may account for the lower prevalence observed.…”

Section: Office Vs Ambulatory Blood Pressure Determinationssupporting

confidence: 77%

“…The mean follow-up period in both of these studies remained at or lower than 10 years. Considering that an increase in the incidence of hypertension is generally found with longer follow-up periods [15][16][17] and that results from actuarial analyses generally show significantly lower recoarctation recurrence rates with the subclavian flap angioplasty technique than with the original end-to-end repair procedure [15,[18][19][20][21] , the discrepancy in findings may be related to differences in the duration of the post-surgical period and the type of corrective surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of the postoperative period and surgical procedure on ambulatory blood pressure-determination of hypertension load after successful surgical repair of coarctation of the aorta

Johnson

Perrault²,

Vobecky³

et al. 1998

European Heart Journal

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Aims This study quantified hypertension load using 24-h ambulatory blood pressure monitoring after successful repair of coarctation of the aorta less than (1) or more than 10 years previously (2) and examined the influence of the surgical procedure (anastomosis or subclavian flap). Methods and ResultsAmbulatory blood pressure recordings were obtained using an Accutracker II monitor every 30 min during the day and hourly, at night. Day and night systolic and diastolic values were higher in coarctation of the aorta than in controls: (day: systolic blood pressure/ diastolic blood pressure: 133/71 6/4 vs 115/66 3/2 night: systolic blood pressure/diastolic blood pressure: 117/61 4/ 4 vs 107/57 3/2 mmHg, P<0·01) and at all times, were higher in coarctation of the aorta (2) than in coarctation of the aorta (1). Clinical daytime systolic hypertension was observed in 20% of recordings from coarctation of the aorta (1) and 49% from coarctation of the aorta (2) while diastolic hypertension was not observed. However, systolic blood pressure and diastolic blood pressure responses to daily activities were significantly higher in coarctation of the aorta than in controls and this was more marked in coarctation of the aorta (2) than in coarctation of the aorta (1). Type of surgery did not affect either hypertension prevalence or blood pressure reactivity. ConclusionsThese observations indicate exaggerated systolic blood pressure and diastolic blood pressure reactivity after repair of coarctation of the aorta, the prevalence of systolic hypertension doubling 10 years after surgery.

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Section: Office Vs Ambulatory Blood Pressure Determinationssupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Influence of the postoperative period and surgical procedure on ambulatory blood pressure-determination of hypertension load after successful surgical repair of coarctation of the aorta

Johnson

Perrault²,

Vobecky³

et al. 1998

European Heart Journal

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“…Похожие результаты описаны группой Melbourne Royal Children's Hospital [12], которая в своем долгосроч-ном наблюдении также выявила, что формирование анастомоза конец в бок с использованием срединно-го доступа может быть предложено при гипоплазии дуги аорты, так как процент рекоарктаций в этой группе крайне низкий. Нами отмечено также влия-ние низкой массы тела (менее 3 кг) на процент реко-арктаций, что подтверждают данные K. Zehr [16]. Другим частым осложнением после реконструк-тивных операций на дуге аорты является резидуаль-ная гипертензия.…”

Section: результаты и обсуждениеunclassified

Surgical treatment of aortic arch malformations in infants under cardiopulmonary bypass

IuN

IuS

et al. 2015

Khir. Z. im. N.I. Pirogova

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ВведениеОбструкция дуги аорты или ее перерыв часто требует неотложного хирургического вмешатель-ства в неонатальном периоде [1]. Хотя результаты реконструктивных операций на дуге аорты были значительно улучшены, отдаленные результаты до сих пор нельзя назвать вполне удовлетворительны-ми. Есть достаточно данных, свидетельствующих о том, что у 16-28% пациентов даже при отсутствии анатомической обструкции в отдаленные сроки со-храняются артериальная гипертензия и системная сосудистая дисфункция [5,11]. Как правило, такие пациенты имеют структурные, функциональные и Results. Follow-up was 42±14 months. In the long-term recoarctation occurred in 7 (13.7%) cases including 6 (18.75%) patients in group 1 and one (3.3%) patient in group 2. Residual hypertension was observed in 12 (23.5%) cases including 10 (37%) patients in group 1 and 2 (8.3%) patients in group 2. Six (50%) patients receive antihypertensive therapy, 5 (41.6%) patients who receive antihypertensive drugs have persistent increase of blood pressure without evidence of anatomic aortic obstruction. Hypertensive response to functional tests was observed in one patient.Conclusions. Aortic arch reconstruction using autoplasty is associated with lower risk of recoarctationand residual hypertension compared with xenopericardial patch application.Keywords: obstructive pathology of the aortic arch, surgical treatment, cardiopulmonary bypass. © Коллектив авторов, 2015

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“…Aortic Coarctation Downstream of Ductus-Juxtaductal coarctation of the aorta is a common acyanotic malformation that is produced by narrowing of the aortic arch adjacent to the insertion of the DA and occurs in approximately 1 in 6000 live births (Zehr et al, 1995). When mild, this pathologic condition leads to upper-extremity hypertension and when severe this condition can result in LV failure and cardiovascular collapse.…”

Section: Disease Statesmentioning

confidence: 99%

In Vitro Hemodynamic Investigation of the Embryonic Aortic Arch at Late Gestation

Pekkan¹,

Dasi²,

Nourparvar³

et al. 2008

Journal of Biomechanics

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This study focuses on the dynamic flow through the fetal aortic arch driven by the concurrent action of right and left ventricles. We created a parametric pulsatile computational fluid dynamics (CFD) model of the fetal aortic junction with physiologic vessel geometries. To gain a better biophysical understanding an in vitro experimental fetal flow loop for flow visualization was constructed for identical CFD conditions. CFD and in vitro experimental results were comparable.Swirling flow during the acceleration phase of the cardiac cycle and unidirectional flow following mid-deceleration phase were observed in pulmonary arteries (PA), head-neck vessels, and descending aorta. Right-to-left (oxygenated) blood flowed through the ductus arteriosus (DA) posterior relative to the antegrade left ventricular outflow tract (LVOT) stream and resembled jet flow. LVOT and right ventricular outflow tract flow mixing had not completed until ~3.5 descending aorta diameters downstream of the DA insertion into the aortic arch. Normal arch model flow patterns were then compared to flow patterns of four common congenital heart malformations that include aortic arch anomalies. Weak oscillatory reversing flow through the DA junction was observed only for the Tetralogy of Fallot configuration. Pulmonary Atresia and Hypoplastic Left Heart Syndrome configurations demonstrated complex, abnormal flow patterns in the PAs and head-neck vessels. Aortic Coarctation resulted in large scale recirculating flow in the aortic arch proximal to the DA. Intravascular flow patterns spatially correlated with abnormal vascular structures consistent with the paradigm that abnormal intravascular flow patterns associated with congenital heart disease influence vascular growth and function.

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Repair of Coarctation of the Aorta in Neonates and Infants: A Thirty-Year Experience

Cited by 71 publications

References 32 publications

Influence of the postoperative period and surgical procedure on ambulatory blood pressure-determination of hypertension load after successful surgical repair of coarctation of the aorta

Influence of the postoperative period and surgical procedure on ambulatory blood pressure-determination of hypertension load after successful surgical repair of coarctation of the aorta

Surgical treatment of aortic arch malformations in infants under cardiopulmonary bypass

In Vitro Hemodynamic Investigation of the Embryonic Aortic Arch at Late Gestation

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