Document Detail


Coarctation of the aorta and ventricular septal defect: should we perform a single-stage repair?
MedLine Citation:
PMID:  11547305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Optimal management for coarctation of the aorta and ventricular septal defect remains controversial. The current study was undertaken to determine outcome, including recoarctation after 2-stage repair, at our institution. METHODS: Between 1984 and 1998, 79 patients younger than 3 months with coarctation and ventricular septal defect underwent 2-stage repair at our institution. The first-stage operation consisted of subclavian flap angioplasty and pulmonary banding. The median age at the time of first operation was 28 days (range, 4-90 days), and median weight was 3.2 kg (range, 1.2-5.1 kg). Hypoplastic aortic arch was present in 27 patients, and coexisting anomalies were present in 13 patients. After a mean interval of 10.4 +/- 9.6 months, they underwent a second-stage repair, with closure of the ventricular septal defect and pulmonary debanding. RESULTS: There were 2 hospital deaths and 4 late deaths. Mean follow-up was 9.2 +/- 4.9 years (range, 2.0-18.3 years), and actuarial survival was 92.3% at 10 years (95% confidence interval, 86.6%-98.3%). Age at first operation, body weight, hypoplastic arch, and coexisting anomalies had no significant influence on overall mortality. Freedom from recoarctation rate was 90.4% at 10 years (95% confidence interval, 83.7%-97.2%). CONCLUSION: To diminish mortality and the recoarctation rate and also to decrease the possibility of complications related to circulatory arrest and allogeneic blood transfusion, 2-stage repair is still an effective technique for coarctation of the aorta associated with ventricular septal defect.
Authors:
Y Isomatsu; Y Imai; T Shin'oka; M Aoki; K Sato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  122     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-07     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Aortic Coarctation / complications*,  mortality,  surgery*
Blood Transfusion / adverse effects
Female
Heart Arrest, Induced / adverse effects
Heart Septal Defects, Ventricular / complications*,  mortality,  surgery*
Hospital Mortality
Humans
Hypothermia, Induced / adverse effects
Infant
Infant, Newborn
Male
Multivariate Analysis
Proportional Hazards Models
Recurrence
Reoperation / adverse effects,  methods*,  mortality
Retrospective Studies
Subclavian Artery / surgery
Surgical Flaps
Survival Analysis
Treatment Outcome
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2001 Sep;122(3):424-6   [PMID:  11547289 ]

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