Contemporary outcomes of aortic arch hypoplasia and coarctation repair in a tertiary paediatric cardiac surgery centre

2021 ◽  
pp. 1-6
Author(s):  
Amr Ashry ◽  
Amer Harky ◽  
Abdulla Tarmahomed ◽  
Christopher Ugwu ◽  
Heba M. Mohammed ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Recurrent Laryngeal Nerve Injury ◽  
Coarctation Repair ◽  
Aortic Arch Reconstruction ◽  
Retrospective Data Collection ◽  
Laryngeal Nerve Injury ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

Abstract Objectives: There are several studies reporting the outcomes of hypoplastic aortic arch and aortic coarctation repair with combination of techniques. However, only few studies reported of aortic arch and coarctation repair using a homograft patch through sternotomy and circulatory arrest with retrograde cerebral perfusion. We report our experience and outcomes of this cohort of neonates and infants. Methods: We performed retrospective data collection for all neonates and infants who underwent aortic arch reconstruction between 2015 and 2020 at our institute. Data are presented as median and inter-quartile range (IQR). Results: The cohort included 76 patients: 49 were males (64.5%). Median age at operation was 16 days (IQR 9–43.25 days). Median weight was 3.5 kg (IQR 3.10–4 kg). There was no 30 days mortality. Three patients died in hospital after 30 days (3.95%), neurological adverse events occurred in only one patient (1.32%) and recurrent laryngeal nerve injury was noted in four patients (5.26%). Only three patients required the support of extracorporeal membrane oxygenation (ECMO) with a median ECMO run of 4 days. Median follow-up was 35 months (IQR 18.9–46.4 months); 5 years survival was 93.42% (n = 71). The rate of re-intervention on the aortic arch was 9.21% (n = 7). Conclusion: Our experience shows excellent outcomes in repairing aortic arch hypoplasia with homograft patch under moderate to deep hypothermia with low in-hospital and 5 years mortality rates.

Results of aortic arch reconstruction in neonates and infants

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
L Ben Mime ◽  
M Emmel ◽  
N Sreeram ◽  
K Brockmeier ◽  
G Bennink ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Arch Reconstruction ◽  
Neonates And Infants ◽  
Arch Reconstruction

scholarly journals Reconstruction of the Aortic Arch in Neonates and Infants: The Importance of Patch Material

2021 ◽  
Vol 12 (4) ◽  
pp. 487-491
Author(s):  
Ingrid M. van Beynum ◽  
Serife Kurul ◽  
Thomas Krasemann ◽  
Michiel Dalinghaus ◽  
Pieter van de Woestijne ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Important Determinant ◽  
Primary Repair ◽  
First Year ◽  
Aortic Arch Reconstruction ◽  
Study Population ◽  
Aortic Arch Repair ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
First Year Of Life

Objectives: Restenosis after aortic arch reconstruction is a known complication in neonates and infants. Homograft is the most commonly used patch material for aortic arch reconstructions in our center. Since 2014, tissue-engineered bovine pericardium (CardioCel) has been used as an alternative. The aim of our study was to determine whether the choice of material affected the development of restenosis in these patients. Methods: Data of all neonates and infants who underwent aortic arch reconstruction with the use of any patch material between 2005 and 2016 were analyzed. Restenosis was defined by the need for reintervention, either percutaneous or surgical. Results: Forty-one patients underwent aortic arch repair. Excluding the 30-day mortality, 36 patients represented the study population. At primary repair, the aortic arch was reconstructed with homograft (n = 26) or CardioCel (n = 10). Restenosis was documented during the first year of life in 13 patients: Six (23%) patients in the homograft group and seven (70%) patients in the CardioCel group ( P = .01). In the homograft group, the median time from operation to first intervention for restenosis was 22.0 (range: 14-32) weeks, as compared to 14.0 (range: 7-21) weeks in the CardioCel group ( P = .04). Conclusion: We conclude that choice of patch material is likely to be an important determinant for the risk of restenosis needing reintervention following reconstruction of the aortic arch in neonates and infants.

scholarly journals Coarctation repair through left thoracotomy in neonates and infants

2018 ◽  
Vol 22 (4) ◽  
pp. 12
Author(s):  
M. M. Belyaeva ◽  
V. N. Ilyin ◽  
O. Yu. Kornouhov ◽  
Yu. Yu. Kornouhov ◽  
O. I. Kalinina
Keyword(s):  
Aortic Arch ◽  
Conflict Of Interest ◽  
Septal Defect ◽  
Coarctation Repair ◽  
Long Term Follow Up ◽  
End To End ◽  
Neonates And Infants ◽  
Aortic Arch Hypoplasia

<p><strong>Aim.</strong> A growing interest in the use of sternotomy and perfusion for repair of aortic coarctation in neonates and infants has enabled us to retrospectively review our own experience in this practice. Our purpose was to determine the efficacy of coarctation repair with extended end-to-end anastomosis through left thoracotomy focusing on a re-intervention rate and dynamics of transverse aortic arch growth during long-term follow-up. <br /><strong>Methods.</strong> One hundred and twenty-four patients under 3 months old who underwent coarctation repair (between 2008 and 2016) were enrolled in this study. In 43 patients (35%), aorta coarctation was combined with ventricular septal defect, 49 patients (39.5%) had transversal aortic arch hypoplasia (Z-score less than –2). All operations were carried out by using extended “end-to-end” anastomosis technique via thoracotomy. In patients with concomitant ventricular septal defect, PA-banding was performed simultaneously. Overall follow-up was 3.6 (0.3–8.0) years. <br /><strong>Results.</strong> Early mortality was 1.6%. Late survival rate was 93.5%. Recurrent aortic arch obstruction was revealed in 10 (8%) patients, on the average, in 6.5 (3.5–15) months after coarctation repair. Management of re-stenosis with balloon aortoplasty was effective in all cases and had no complications. A statistically significant growth (p&lt;0.001) of the transverse aortic arch was observed in those patients who had hypoplasia of the arch before surgery. <br /><strong>Conclusion.</strong> Repair of coarctation of the aorta by resection and extended “end-to-end” anastomosis via thoracotomy without perfusion has low operative mortality, an excellent survival rate and a reduced rate of balloon re-intervention. Patients with baseline moderate transverse aortic arch hypoplasia demonstrate a growth of the aorta up to normal values in long-term follow-up. Endovascular balloon dilatation of aortic re-coarctation zone during long-term follow-up is an effective and safe procedure. <br />Received 20 June 2018. Revised 5 September 2018. Accepted 12 September 2018.<br /><strong>Funding:</strong> The study did not have sponsorship.<br /><strong>Conflict of interest:</strong> Authors declare no conflict of interest.<br /><strong>Author contributions</strong><br />Conception and study design: V.N. Ilyin<br />Data collection and analysis: M.M. Belyaeva, O.Yu. Kornoukhov, Yu.Yu. Kornoukhov, O.I. Kalinina<br />Drafting the article: M.M. Belyaeva <br />Critical revision of the article: V.N. Ilyin, O.Yu. Kornoukhov<br />Final approval of the version to be published: M.M. Belyaeva, V.N. Ilyin, O.Yu. Kornoukhov, Yu.Yu. Kornoukhov, O.I. Kalinina</p>

scholarly journals The analyze of neurological complications after aortic arch reconstruction in patients with proximal aortic dissection

2015 ◽  
Vol 17 (2) ◽  
pp. 35
Author(s):  
A. M. Chernyavskiy ◽  
S. A. Alsov ◽  
M. M. Lyashenko ◽  
D. A. Sirota ◽  
D. S. Khvan ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Neurological Complications ◽  
Pathological Process ◽  
Arterial Lesions ◽  
Aortic Arch Reconstruction ◽  
Almost All ◽  
Arch Reconstruction ◽  
The Brain

The article analyzes the neurological complications after interventions on the ascending aorta and the aortic arch in dissection I type by De Bakey. Group of authors investigated over a decade of experience in surgery of aortic dissection in both acute and chronic. Authors estimated the incidence of neurological complications after surgical intervention in 124 patients in the early post-operative and long term period. It were studied both qualitative measures (methods of reconstruction of the aortic arch, type of cerebral perfusion, the etiology of the pathological process, comorbidities) and quantitative (the duration of the different stages of surgery, age, height, weight). The analysis revealed that almost all cases of strokes were observed in the older age group and were associated with concomitant occlusive-stenotic arterial lesions caused by Takayasu's syndrome and atherosclerosis, as well as a set of related diseases. Increase in the number of strokes contribute to more complex, and therefore more time-consuming intervention types of reconstruction of the aortic arch. Antegrade perfusion of the brain, to our knowledge, did not have statistically significant advantages over retrograde perfusion or hypothermic circulatory arrest of the brain.

Sign in / Sign up

Export Citation Format

Share Document