Analysis of early results of 43 children with aortic arch lesion after operation

Abstract

Objective To analyze the clinical data of aortic arch lesions after operation in order to provide better operation and decrease the mortality and shorten the duration of intensive care unit(ICU) treatment. Methods Forty-three children with aortic arch lesions including 26 male and 17 female in Fuwai Angiocardiopathy Hospital between Jan.and Sep.2012 were enrolled.The ages ranged from 29 days to 10 years old with the median age of 6 months and the weight ranged from 3.2 kg to 38.0 kg with the median weight of 6.0 kg.Nine cases were simple aortic arch lesions, while 34 cases were associated with 2 or more complex cardiac anomalies.The cases were divided into groups according to the age and residence time in ICU. Results The median duration of mechanical ventilation was 23 hours and the median duration of residence time in ICU was 3 days.There were 3 postoperative deaths.Infants younger than 6 months needed more time of mechanical ventilation and longer ICU stay than children older than 6 months.The single factor analysis revealed that young age, low weight, combined with complex cardiac anomalies, and long time of cardiopulmonary bypass and mechanical ventilation were risk factors of prolonged stay in ICU.Postoperative complications occurred in 15 cases: 12 cases had the pulmonary infection, 5 cases had systemic capillary leak syndrome, 2 cases had tracheal stenosis, and 2 cases had low cardiac output syndrome.Extracorporeal membrane oxygenation support and cardiopulmonary resuscitation were guarantees of successful operation of low cardiac output syndrome. Conclusions Outcomes of repair of aortic arch lesion were good, so timely operation should be preformed for aortic arch lesions infants with asso-ciated cardiac anomalies, but there is risk of operation and infants need longer duration of ICU stay and tend to have more postoperative complications.The preliminary experiences suggested that it would be better for the children older than 6 months with aortic arch lesion to undertake operation as they tend to have less postoperative complications. Key words: Congenital heart disease; Aortic arch lesion; Coarctation of aorta; Interrupted aortic arch; Posto-perative complication; Risk factor