Risk factors for recurrence after surgical repair of coarctation of the aorta in children: a single-center experience based on 51 children

Zhao, Zhenjiang; Pan, Zhengxia; Wu, Chun; Tian, Jie; Qin, Jinjie; Zhang, Yulin; Jin, Xin

doi:10.3389/fcvm.2023.1144755

Cited by 2 publications

(2 citation statements)

References 40 publications

(58 reference statements)

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“…As mentioned above, other studies also describe the association of recoarctation with a higher arch gradient before discharge [23][24][25]30]. However, there is insufficient data on the connection between inotropic support and recoarctation.…”

Section: Discussionmentioning

confidence: 96%

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Results of Aortic Coarctation Repair in Low- and Normal Birth-Weight Neonates: A Propensity Score-Matched Analysis

Krylova,

Svobodov,

Tumanyan

et al. 2023

Life

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Introduction: Surgical treatment of aortic coarctation in low-birth-weight (LBW) neonates is associated with risks of higher hospital mortality rates and recoarctation development in the long-term. The goal of our study was to compare the results of surgical treatment of aortic coarctation in LBW neonates and normal-weight patients, to identify predictors of recoarctation in the long-term among LBW patients. Materials and methods: A retrospective study was performed to analyse the patients who had undergone resection of isolated aortic coarctation between 2005 and 2022. Overall analysis included 521 patients under the age of 30 days, 89 LBW patients and 432 patients with normal body weight. Propensity score matching (PSM) was performed at a ratio of 1:1 for the statistical adjustment of original patients’ data in both groups. Results: All patients underwent standard resection of aortic coarctation with extended end-to-end anastomosis. Hospital mortality among LBW patients was 8% and in patients with normal weight the mortality amounted to 1% (p = 0.030). LBW patients were transferred to other hospitals more often than normal-weight patients who were more often discharged (p < 0.001). In the long-term, period mortality was not statistically significantly different (p = 0.801). The freedom from reoperation in the group of normal-weight children was 87%, whereas in the LBW patients the rate was 63% (log rank test, p = 0.104). In the multivariate regression model, the most significant risk factors for reoperation were as follows: preoperative inotropes administration (OR (95% CI) 4.369 (1.316–14.51)) and pressure gradient across aortic arch before discharge (OR (95% CI) 1.081 (1.014–1.153)). Conclusions: Hospital mortality was higher among LBW patients (p = 0.030). There was a statistical trend of differences in reoperation rates: in the long-term among LBW patients, a higher reintervention probability remains. Moreover, the LBW group initially had more severe clinical condition in terms of cardiac failure and impaired renal function. Factors associated with the risk of recoarctation were preoperative inotropes infusion and pressure gradient across aortic before discharge.

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Section: Discussionmentioning

confidence: 96%

“…The most significant were the gradient before discharge and preoperative inotropes administration. Several other authors also mentioned the association between higher pressure gradient across aortic arch after repair and recoarctation development in the long-term, expectedly [23][24][25].…”

Section: Discussionmentioning

confidence: 99%