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The experience of one-stage surgical treatment with extended end-to-side anastomosis for 208 cases with aortic coarctation combined with ventricular septal defect
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Affiliation:

1.Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, China;2.Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou, Guangdong 510623, China;3.Division of Hypertension and Vascular Diseases, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China)

Clc Number:

R6

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    Abstract:

    Aim To summarize the experience of one-stage surgical treatment of aortic coarctation (CoA) combined with ventricular septal defect (VSD) with extended end-to-side anastomosis in recent years. Methods The data from 208 cases with CoA combined with VSD admitted to hospital between January 2010 to October 2017 were collected and analyzed. There were 137 boys and 71 girls, the median age was 54 (5～730) days, the median weight was 4.0 (1.8～9.9) kg. Extended end-to-side anastomosis was used to correct the CoA, and the VSD was repaired simultaneously by an incision through median sternotomy. All operations were performed by the same group of surgeons. The data were analyzed by SPSS 20.0. Results Early death occurred in 6 cases (2.9%) and late death occurred in 3 cases (1.4%).Recoarctation developed in 16 cases (7.7%) and reoperation occurred in 19 cases (9.1%). The level of brain natriuretic peptide (BNP) increased remarkably before operation but showed no obvious change after operation. After operation, transcoarctation gradient pressure was reduced, and the transcutaneous oxygen saturation, C-reactive protein (CRP), lactate and creatinine were increased. Preoperative hypertension existed in 104 cases (53.0%), and after operation, blood pressure returned to the baseline level in 30 cases (28.8%) and continued to rise in 35 cases (33.7%). Higer transcoarctation gradient was the risk factor for postoperative recoarctation. Conclusions Correcting the CoA combined with VSD simultaneously with extended end-to-side anastomosis by an incision through median sternotomy was effective and safe, and the outcomes of immediate and medial-term were satisfactory, with low rates of mortality and recoarctation. Higer transcoarctation gradient pressure was the risk factor for postoperative recoarctation.

    Reference
    [1] HOFFMAN J I E, KAPLAN S.The incidence of congenital heart disease.J Am Coll Cardiol, 2,9(12):1890-1900.
    [2] QUAEGEBEUR J M, JONAS R A, WEINBERG A D, et al.Outcomes in seriously ill neonates with coarctation of the aorta.A multiinstitutional study.J Thorac Cardiov Sur, 4,8(5):841.
    [3] WALTERS H L, IONAN C E, THOMAS R L, et al.Technique of single-stage repair of coarctation of the aorta with ventricular septal defect.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 8,1(1):22-30.
    [4] WALTERS H L, IONAN C E, THOMAS R L, et al.Single-stage versus 2-stage repair of coarctation of the aorta with ventricular septal defect.J Thorac Cardiov Sur, 8,5(4):754-761.
    [5] LEE M G Y, BRINK J, GALATI J C, et al.End-to-side repair for aortic arch lesions offers excellent chances to reach adulthood without reoperation.Ann Thorac Surg, 4,8(4):1405-1411.
    [6] MAVROUDIS C, BACKER C L.小儿心脏外科学.上海:上海世界图书出版公司, 2014.
    [7] 陈欣欣, 张镜芳, 庄建, 等.经胸骨正中切口一期矫治小儿主动脉缩窄及合并畸形.中华胸心血管外科杂志, 6,2(6):374-376.
    [8] 张胜豪, 刘恒亮, 毛磊, 等.血清糖类抗原125及脑钠肽水平对心肌梗死后心力衰竭发生及严重程度的预测价值.中国动脉硬化杂志, 9,7(1):55-60.
    [9] 张鹤, 李玖军.先天性心脏病患儿血浆脑钠肽水平与左心功能的关系.中国当代儿科杂志, 2,4(1):42-44.
    [10] BROWN M L, BURKHART H M, CONNOLLY H M, et al.Coarctation of the aorta:life long surveillance is mandatory following surgical repair.J Am Coll Cardiol, 3,2(11):1020.
    [11] 沈君.婴幼儿先天性心脏病围术期hs-CRP和cTnI监测的临床意义.中国循证心血管医学杂志, 3,5(1):40-42.
    [12] 黄继红, 徐卓明, 张明杰, 等.区域组织氧饱和度和乳酸联合预测先天性心脏病术后早期转归.中国胸心血管外科临床杂志, 9,6(8):772-776.
    [13] PEDERSEN K R, HJORTDAL V E, CHRISTENSEN S, et al.Clinical outcome in children with acute renal failure treated with peritoneal dialysis after surgery for congenital heart disease.Kidney Int Suppl, 8,8:S81-S86.
    [14] BONDY C A.Aortic coarctation and coronary artery disease:the XY factor.Circulation, 2,6(1):5-7.
    [15] VIGNESWARAN T V, VIGNESWARAN T V, SINHA M D, et al.Hypertension in coarctation of the aorta:challenges in diagnosis in children.Pediatr Cardiol, 8,9(1):1-10.
    [16] BHAT M A, NEELAKANDHAN K S, UNNIKRISHNAN M, et al.Fate of hypertension after repair of coarctation of the aorta in adults.Brit J Surg, 1,8(4):536-538.
    [17] 吴雨昊, 周悦航, 金鑫, 等.86例主动脉缩窄合并心内畸形患婴的一期手术治疗效果.中华胸心血管外科杂志, 9,5(9):526-529.
    [18] 高伟年, 陈欣欣, 夏园生, 等.主动脉扩大端端吻合术治疗婴幼儿主动脉缩窄的中期随访.中华小儿外科杂志, 3,4(7):489-492.
    [19] 葛同开, 陈寄梅, 庄建, 等.117例主动脉缩窄合并室间隔缺损一期矫治手术的疗效.中华胸心血管外科杂志, 5,1(3):138-141.
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LIU Xiang, SHAO Yijia, MA Li, ZOU Minghui, CHEN Weidan, CUI Yanqin, CHEN Xinxin. The experience of one-stage surgical treatment with extended end-to-side anastomosis for 208 cases with aortic coarctation combined with ventricular septal defect[J]. Editorial Office of Chinese Journal of Arteriosclerosis,2021,29(6):523-528.

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History
  • Received:September 18,2020
  • Revised:April 12,2021
  • Online: June 11,2021
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