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Published on: December 11, 2017
Outcomes of aortopexy for patients with congenital heart disease
Sang-Yun Lee1, Soo-Jin Kim, Jae-Suk Baek
1Department of Pediatrics, Sejong Cardiovascular Institute, Bucheon-si, Republic of Korea.
Insights
Aortopexy surgery effectively widens the airway in patients with congenital heart disease, improving breathing. This procedure is a valuable option for those experiencing airway compression.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Congenital heart disease can lead to airway compression.
- Aortopexy is a surgical technique to address aortic arch issues.
- Evaluating aortopexy's impact on airway is crucial.
Purpose of the Study:
- To assess the effectiveness of aortopexy in managing airway compression in pediatric patients with congenital heart disease.
- To evaluate changes in airway dimensions and interaortic distance post-aortopexy.
Main Methods:
- Retrospective review of 16 patients with congenital heart disease undergoing aortopexy.
- Chest computed tomography (CT) used to measure airway and interaortic distances.
- Comparison of airway severity before and after aortopexy, including long-term follow-up.
Main Results:
- Aortopexy significantly improved the diameter ratio of the compressed bronchus to the trachea.
- The interaortic distance index increased post-aortopexy.
- Statistically significant improvements were observed in airway dimensions and interaortic distance.
Conclusions:
- Aortopexy is a beneficial surgical intervention for airway compression in patients with congenital heart disease.
- Consider aortopexy for patients with unusual clinical courses related to airway compression.
- Chest CT is a valuable tool for evaluating aortopexy outcomes.
Abstract:
Aortopexy is a surgical procedure in which the aortic arch is fixed at other structures, thus widening the interaortic space. This study aimed to evaluate the outcome of aortopexy by means of chest computed tomography for patients with congenital heart disease. The study retrospectively reviewed the medical records of 16 patients with congenital heart disease who had undergone aortopexy by compressed airway. The severity of compressed bronchus before aortopexy, immediately after aortopexy (≤ 1 month), and after the patient had grown up were compared. To estimate the efficacy of the aortopexy, the interaortic distance index was calculated. Of the 16 patients, aortopexy was performed at the ascending aorta in 7, at the descending aorta in 7, and at the transverse arch in 2. The diameter ratio between the narrowest bronchus and the trachea was improved after aortopexy, as was the diameter ratio before aortopexy versus immediately after aortopexy (n = 9; p = 0.018) and the diameter ratio before aortopexy versus after the patient had grown up (n = 11; p = 0.006). Also, the interaortic distance index was increased after aortopexy, as was the diameter before aortopexy versus immediately after aortopexy (n = 9; p = 0.039) and the diameter before aortopexy versus after the patient had grown up (n = 11; p = 0.014). The study had one case of mortality due to sepsis. As shown by the results, aortopexy in patients with a compressed airway between arches is a useful surgical option. Such a compressed airway between arches should be considered for patients with an unusual clinical course before and after open heart surgery.
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