We sought to determine the prevalence of outcomes and associated patient and management factors for neonates with interrupted aortic arch. From 1987 to 1997, a total of 472 neonates were enrolled prospectively from 33...We sought to determine the prevalence of outcomes and associated patient and management factors for neonates with interrupted aortic arch. From 1987 to 1997, a total of 472 neonates were enrolled prospectively from 33 institutions. Competing risks methodology was used to determine simultaneous risk and associated incremental risk factors for death, initial and subsequent left ventricular outflow tract procedures, and arch reinterventions. Overall survival was 59%at 16 years after study entry but improved with successive birth cohort. In general, risk factors for death in each of the competing risks analyses included lower birth weight, younger age at study entry, type B interrupted aortic arch, and major associated cardiac anomalies. Of 453 patients who had interrupted aortic arch repair, after 16 years 33%had died and 28%had undergone an arch reintervention. Reintervention was more likely for those who had truncus arteriosus repair, interrupted aortic arch repair by a method other than direct anastomosis with patch augmentation, and the use of polytetrafluoroethylene as either an interposition graft or a patch. From study entry, competing risks after 16 years showed that 28%had died and 34%had undergone an initial left ventricular outflow tract procedure. Initial left ventricular outflow tract procedure was more likely for those with single ventricle, type B interrupted aortic arch, bicuspid aortic valve, or anomalous right subclavian artery. Among those who had undergone an initial left ventricular out-flow tract procedure, after 16 years 37%had died and 28%had undergone a second procedure. Anatomic features affect mortality and initial left ventricular outflow tract procedures, whereas characteristics of the arch repair affect arch reintervention.展开更多
主动脉弓畸形是一种少见的先天性心血管畸形,新生儿的发病率约为万分之一,在先天性心脏病患者中约占1%-4%[1]。主动脉弓畸形包括主动脉弓缩窄（coarctation of aorta,COA）、主动脉弓离断（interruption of aortic arch,IAA）、右位主...主动脉弓畸形是一种少见的先天性心血管畸形,新生儿的发病率约为万分之一,在先天性心脏病患者中约占1%-4%[1]。主动脉弓畸形包括主动脉弓缩窄（coarctation of aorta,COA）、主动脉弓离断（interruption of aortic arch,IAA）、右位主动脉弓、先天性血管环和悬带,其中COA和IAA较为常见,这两种畸形常并发其他心血管畸形,如室间隔缺损、动脉导管未闭等。展开更多
文摘We sought to determine the prevalence of outcomes and associated patient and management factors for neonates with interrupted aortic arch. From 1987 to 1997, a total of 472 neonates were enrolled prospectively from 33 institutions. Competing risks methodology was used to determine simultaneous risk and associated incremental risk factors for death, initial and subsequent left ventricular outflow tract procedures, and arch reinterventions. Overall survival was 59%at 16 years after study entry but improved with successive birth cohort. In general, risk factors for death in each of the competing risks analyses included lower birth weight, younger age at study entry, type B interrupted aortic arch, and major associated cardiac anomalies. Of 453 patients who had interrupted aortic arch repair, after 16 years 33%had died and 28%had undergone an arch reintervention. Reintervention was more likely for those who had truncus arteriosus repair, interrupted aortic arch repair by a method other than direct anastomosis with patch augmentation, and the use of polytetrafluoroethylene as either an interposition graft or a patch. From study entry, competing risks after 16 years showed that 28%had died and 34%had undergone an initial left ventricular outflow tract procedure. Initial left ventricular outflow tract procedure was more likely for those with single ventricle, type B interrupted aortic arch, bicuspid aortic valve, or anomalous right subclavian artery. Among those who had undergone an initial left ventricular out-flow tract procedure, after 16 years 37%had died and 28%had undergone a second procedure. Anatomic features affect mortality and initial left ventricular outflow tract procedures, whereas characteristics of the arch repair affect arch reintervention.
文摘主动脉弓畸形是一种少见的先天性心血管畸形,新生儿的发病率约为万分之一,在先天性心脏病患者中约占1%-4%[1]。主动脉弓畸形包括主动脉弓缩窄（coarctation of aorta,COA）、主动脉弓离断（interruption of aortic arch,IAA）、右位主动脉弓、先天性血管环和悬带,其中COA和IAA较为常见,这两种畸形常并发其他心血管畸形,如室间隔缺损、动脉导管未闭等。
