Document Detail

Repair of critical aortic coarctation in neonatal age.
MedLine Citation:
PMID:  11803319     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The data of 111 (male: 64; female: 47) in the period of 1967 until 12/93 consecutive operated neonatals (<1 month) were studied retrospectively (mean weight 3270 g, mean age at operation 14 days). METHODS: Preductal anatomy was present in 96 patients. The coarctation was isolated in 30 patients (group I), 34 patients had additional large ventricular septal defects (group II) and 47 had complex heart disease (group III). The preoperative heart catheterization revealed a gradient of <20 mmHg in 35%, >20 mmHg in 51.4% and >50 mmHg in 12.9%. The indication for repair was conservatively untreatable heart insufficiency. In the vast majority (n=97) of patients resection and end-to-end anastomosis were performed, in 31 cases using an absorbable suture, in 18 of these using a continuous suture line. In 4 patients a subclavian flap angioplasty (SFA) was done, in 4 a patch enlargement, 4 times a repair was described as not possible and in 2 patients there was no gradient after division of the ductus. RESULTS: Early lethality was 3.3% (n=1) in group I, 24.2% (n=8) died in group II and 39.1% (n=18) in group III; after introducing Prostaglandin E1 0% in group I, 15% in II and 25% in III. Relevant recoarctation (Gradient >20 mmHg) developed in 9 (among them 4 with hypoplastic arch, 2 after SFA) of the 77 long-term survivors; 6 of these were reoperated on, 5 without residual gradient, 1 with a gradient of 25 mmHg without clinical symptoms (after 4 years). In the last 3 patients a balloon dilation was carried out without residual gradient. Mean follow-up time was 6 (0-24) years. No patient needs antihypertensive treatment. The cumulative survival rate is 96.7% (+6.6%) for group I, 77.4% (+15.0%) for II and 51.9% (+16.6%) for III. CONCLUSIONS: Resection and end-to-end anastomosis using a continuous absorbable suture is the method of choice at theoretical considerations and in our experiences. The number of recoarctations in neonatal age is relatively high; reinterventions (operation respectively dilation) can be done safely and successfully.
B Korbmacher; O N Krogmann; S Rammos; E Godehardt; T Volk; H D Schulte; E Gams
Related Documents :
11689799 - Stroke in surgery of the thoracic aorta: incidence, impact, etiology, and prevention.
8404089 - Progression of aortic stenosis. role of age and concomitant coronary artery disease.
11887049 - Correlation between age and vital organ function following deep hypothermic circulatory...
15450569 - Ascending aortic origin of a branch pulmonary artery--surgical management and long-term...
2627449 - Surgical correction of descending thoracic aortic aneurysms with shunt or bypass techni...
22700259 - High-intensity focused ultrasound treatment of liver tumours: post-treatment mri correl...
2407959 - Preliminary report of the stroke prevention in atrial fibrillation study.
20392579 - Myringosclerosis after tympanostomy tube insertion: relation with tube retention time a...
11726899 - Extracardiac conduit versus lateral tunnel cavopulmonary connections at a single instit...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  43     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-22     Completed Date:  2002-05-03     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Clinic of Thoracic and Cardiovascular Surgery, Medical Center, Düsseldorf, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Age Factors
Anastomosis, Surgical
Aortic Coarctation / mortality*,  physiopathology,  surgery*
Critical Illness / mortality*,  therapy*
Hemodynamics / physiology
Infant Mortality
Infant, Newborn
Retrospective Studies
Severity of Illness Index
Survival Rate
Suture Techniques

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Educational preparedness for physical therapists and occupational therapists in burn care.
Next Document:  Lung impairment following cardiac surgery in patients with pulmonary hypertension.