Background： Coarctation of the aorta （CoA） with aortic arch hypoplasia （AAH） is a relatively common congenital heart disease in clinical practice. Nonetheless, the corrective surgical technique for infants and ch...Background： Coarctation of the aorta （CoA） with aortic arch hypoplasia （AAH） is a relatively common congenital heart disease in clinical practice. Nonetheless, the corrective surgical technique for infants and children is a clinical problem that remains controversial. In this study, we sought to evaluate the surgical effects of aortic arch （AA） reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch for infants and young children with CoA and AAH. Methods： Between January 2009 and December 2015, a total of 22 infants and young children with CoA and AAH who underwent coarctation resection and aortoplasty with autologous pulmonary artery patch were enrolled in this study. The median age of patients was 4.5 （Q1, Q3： 2.0, 14.0） months and the median body weight was 5.75 （Q1, Q3： 4.10, 9.38） kg. All patients were diagnosed with CoA and AAH, and concomitant cardiac anomalies were corrected in one stage. Perioperative and postoperative data were collected and analyzed using the paired sample t-test. Results： No perioperative deaths occurred. No residual obstruction was detected by echocardiography. The postoperative pressure difference across the repaired segment of CoA was 14.05 ± 4.26 mmHg （1 mmHg = 0.133 kPa）, which was smaller than the preoperative pressure difference （48.30 ± 15.73 mmHg; t = -10.119, P 〈 0.001）. The median follow-up time was 29.0 （Q1, Q3： 15.5, 57.3） months. There was no death during the follow-up period, and all patients experienced obvious clinical improvement. Only one child underwent subsequent aortic balloon angioplasty due to restenosis. Computed tomography angiography showed that the AA morphology was smooth, with no aortic aneurysm or angulation deformity. Conclusion： AA reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch could effectively correct CoA with AAH, and the rate of reintervention for restenosis is low.展开更多
目的总结儿童主动脉缩窄(coarctation of aorta,COA)诊断和治疗中的经验教训。方法2000年1月～2006年7月6年间在我院确诊并接受了内外科治疗的75例7岁以下COA病例,对一般临床资料、超声心动图、磁共振(MRI)和选择性心血管造影结果、手...目的总结儿童主动脉缩窄(coarctation of aorta,COA)诊断和治疗中的经验教训。方法2000年1月～2006年7月6年间在我院确诊并接受了内外科治疗的75例7岁以下COA病例,对一般临床资料、超声心动图、磁共振(MRI)和选择性心血管造影结果、手术方法、随访结果和预后进行分析。结果外科治疗组(52例):住院期间死亡2例(3.85%),存活的50例经1个月～6年的随访,治愈47例,3例术后1～2年证实再缩窄行球囊扩张术。内科治疗组(23例):20例单纯、局限的COA行球囊扩张术,1例再狭窄行2次球囊扩张;3例合并弓发育不良的COA行球囊扩张,有2例症状复发,其中1例因重度肺动脉高压放弃外科手术治疗,1例扩张后2年行外科手术治疗。结论COA治疗上以外科手术为主,手术方法有补片加宽、切除端端吻合、左锁骨下动脉翻转等,合理选择术式效果令人满意;单纯、局限的COA和外科手术纠正后发生的再狭窄是球囊扩张术的较好指征,球囊扩张术对合并弓发育不良的COA的疗效不佳。展开更多
文摘Background： Coarctation of the aorta （CoA） with aortic arch hypoplasia （AAH） is a relatively common congenital heart disease in clinical practice. Nonetheless, the corrective surgical technique for infants and children is a clinical problem that remains controversial. In this study, we sought to evaluate the surgical effects of aortic arch （AA） reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch for infants and young children with CoA and AAH. Methods： Between January 2009 and December 2015, a total of 22 infants and young children with CoA and AAH who underwent coarctation resection and aortoplasty with autologous pulmonary artery patch were enrolled in this study. The median age of patients was 4.5 （Q1, Q3： 2.0, 14.0） months and the median body weight was 5.75 （Q1, Q3： 4.10, 9.38） kg. All patients were diagnosed with CoA and AAH, and concomitant cardiac anomalies were corrected in one stage. Perioperative and postoperative data were collected and analyzed using the paired sample t-test. Results： No perioperative deaths occurred. No residual obstruction was detected by echocardiography. The postoperative pressure difference across the repaired segment of CoA was 14.05 ± 4.26 mmHg （1 mmHg = 0.133 kPa）, which was smaller than the preoperative pressure difference （48.30 ± 15.73 mmHg; t = -10.119, P 〈 0.001）. The median follow-up time was 29.0 （Q1, Q3： 15.5, 57.3） months. There was no death during the follow-up period, and all patients experienced obvious clinical improvement. Only one child underwent subsequent aortic balloon angioplasty due to restenosis. Computed tomography angiography showed that the AA morphology was smooth, with no aortic aneurysm or angulation deformity. Conclusion： AA reconstruction with coarctation resection and aortoplasty with autologous pulmonary artery patch could effectively correct CoA with AAH, and the rate of reintervention for restenosis is low.
文摘目的总结儿童主动脉缩窄(coarctation of aorta,COA)诊断和治疗中的经验教训。方法2000年1月～2006年7月6年间在我院确诊并接受了内外科治疗的75例7岁以下COA病例,对一般临床资料、超声心动图、磁共振(MRI)和选择性心血管造影结果、手术方法、随访结果和预后进行分析。结果外科治疗组(52例):住院期间死亡2例(3.85%),存活的50例经1个月～6年的随访,治愈47例,3例术后1～2年证实再缩窄行球囊扩张术。内科治疗组(23例):20例单纯、局限的COA行球囊扩张术,1例再狭窄行2次球囊扩张;3例合并弓发育不良的COA行球囊扩张,有2例症状复发,其中1例因重度肺动脉高压放弃外科手术治疗,1例扩张后2年行外科手术治疗。结论COA治疗上以外科手术为主,手术方法有补片加宽、切除端端吻合、左锁骨下动脉翻转等,合理选择术式效果令人满意;单纯、局限的COA和外科手术纠正后发生的再狭窄是球囊扩张术的较好指征,球囊扩张术对合并弓发育不良的COA的疗效不佳。
