Related Experiment Videos
A postoperative follow-up study of infantile coarctation of the aorta
S Abdulla1, N Malmgren, G Björkhem
1Department of Paediatrics, Al Wasl Hospital, Dubai, United Arab Emirates.
Insights
Surgical repair of coarctation of the aorta in infancy shows good long-term results. Subclavian flap aortoplasty (SFA) is associated with fewer complications than resection with end-to-end anastomosis (REE).
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Congenital Heart Disease
Background:
- Coarctation of the aorta is a congenital heart defect requiring surgical intervention in infancy.
- Long-term outcomes and potential complications of different surgical techniques need thorough evaluation.
- Follow-up studies are crucial for assessing the efficacy and safety of pediatric cardiac surgeries.
Purpose of the Study:
- To evaluate the long-term outcomes of surgical repair for coarctation of the aorta in infancy.
- To compare the effectiveness and complication rates of different surgical methods, including resection with end-to-end anastomosis (REE) and subclavian flap aortoplasty (SFA).
- To assess the incidence of recoarctation and other potential sequelae in a pediatric cohort.
Main Methods:
- A retrospective follow-up study of 16 patients operated on for coarctation during infancy.
- Surgical techniques included resection with end-to-end anastomosis (REE), subclavian flap aortoplasty (SFA), patch aortoplasty, and resection and SFA.
- Follow-up duration ranged from 4.5 to 11 years, with assessment of recoarctation, hypertension, and limb blood pressure gradients.
Main Results:
- One patient (6%) developed recoarctation after REE repair in early infancy.
- Patients undergoing REE repair (excluding the one with recoarctation) showed normal pulses, no hypertension, and normal resting arm/leg pressure gradients.
- Among patients treated with SFA or aortoplasty, 58% had diminished left arm radial pulses, and 81% had smaller, shorter left arms, though without functional limitation or hypertension.
Conclusions:
- Surgical repair of coarctation of the aorta in infancy generally yields favorable long-term outcomes.
- Subclavian flap aortoplasty (SFA) appears to be associated with a lower risk of recoarctation compared to resection with end-to-end anastomosis (REE).
- While SFA may lead to limb length discrepancies and diminished pulses, these findings do not typically impact arm function or lead to hypertension.
Abstract:
Follow-up investigations were performed in 16 patients operated on for coarctation during infancy. The follow-up period ranged from 4.5 to 11 years (median 5.5 years). Four different surgical techniques were used: resection with end-to-end anastomosis (REE) (4 patients), subclavian flap aortoplasty (SFA) (10 patients), patch aortoplasty (1 patient) and resection and SFA (1 patient). One patient developed recoarctation (6%). She had been operated on by REE at 7 days of age. The other three patients operated on by REE had equal pulses in the arms and legs; none had hypertension and all had normal arm/leg pressure gradients at rest. Seven (58%) of the 12 patients operated on by SFA or aortoplasty had weak radial pulses in the left arm but no limitation of left arm function. The left a rm showed a normal bone age but was smaller and shorter than the right arm in 9 (81%) of the patients. None of the patients operated on by SFA had hypertension and the arm/leg gradient at rest was normal.