| Coarctation of the aorta and ventricular septal defect: should we perform a single-stage repair? | |
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MedLine Citation:
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PMID: 11547305 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Y Isomatsu; Y Imai; T Shin'oka; M Aoki; K Sato |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2001-09-07 Completed Date: 2001-10-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 524-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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J Thorac Cardiovasc Surg. 2001 Sep;122(3):424-6
[PMID:
11547289
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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