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[Aortic coarctation in childhood. Surgical experience in 120 cases]
Insights
This study reviewed surgical outcomes for coarctation of the aorta and tubular hypoplasia of the aortic isthmus in children. While coarctation of the aorta had acceptable mortality, tubular hypoplasia presented significant challenges with high mortality.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Thoracic Surgery
Context:
- Coarctation of the aorta and tubular hypoplasia of the aortic isthmus are critical congenital heart defects.
- Surgical management in pediatric patients presents unique challenges.
- Outcomes data for these conditions are essential for clinical practice improvement.
Purpose:
- To review surgical outcomes for coarctation of the aorta and tubular hypoplasia of the aortic isthmus in pediatric patients.
- To analyze associated lesions, hospital mortality, and postoperative complications.
- To evaluate the effectiveness of surgical interventions in a large pediatric cohort.
Summary:
- 112 cases of coarctation of the aorta and 8 cases of tubular hypoplasia of the aortic isthmus were operated on in children under 7 years.
- Coarctation of the aorta cases, predominantly in infants, showed 14.2% hospital mortality with common associated lesions including persistent ductus arteriosus and ventricular septal defect.
- Tubular hypoplasia cases, all infants, had a 62.5% hospital mortality, frequently with associated persistent ductus arteriosus and ventricular septal defect; broncopulmonary disorders were the main cause of death.
Impact:
- Provides crucial data on surgical outcomes for rare pediatric aortic arch anomalies.
- Highlights the significant difference in outcomes between coarctation of the aorta and tubular hypoplasia.
- Informs surgical strategies and emphasizes the need for managing associated lesions and postoperative pulmonary complications.
Abstract:
112 cases of coarctation of the aorta and 8 cases of tubular hypoplasia of the aortic isthmus operated upon in the Children's Hospital "La Paz" from Madrid, are reviewed. All children were under 7 years of age. 64.2% of the cases of aortic coarctation were in the first year of life, 47.3% of them had associated lesions, being the most frequently present persistent ductus arteriosus and ventricular septal defect. Hospital mortality was 14.2%, what is considered as very acceptable. All the children operated upon for the correction of tubular hypoplasia of the aortic isthmus were in the first year of age. 75% of them had associated ductus arteriosus and ventricular septal defect, being hospital mortality of 62.5%. Most frequent postoperative complications and cause of death were due to broncopulmonary disorders secondary to the existence of a previous pulmonary hypertension.