Clinical analysis of surgical treatment for aortic coarctation

Abstract

Objective To summarize the methods and experiences of one-stage repair of aortic coarctation. Methods During January 2009 and September 2016, 31 patients underwent surgery for coarctation of aorta (COA) in our department. Of them, fifteen patients were accompanied by patent ductus arteriosus (PDA), five associated with ventricular septal defect (VSD), five with VSD and PDA, and six patients were single COA. All patients accepted one-stage repair and follow-up. The surgical strategies and follow-up results were retrospectively reviewed. Results Excision of coarctation and anastomoses was performed in 24 patients, a bypass with artificial graft was performed in 3 patients, longitudinally section transverse suture was performed in 2 patients, and aortoplasty with patch graft was used in 2 patients. Accompanied intracardiac malformations were repaired simutaneously. One patient died of low cardiac output syndrome 1 d after operation. Other patients recovered smoothly. Thirty patients were followed up from 6 months to 7 years. The anastomotic systolic pressure difference disappeared in 21 patients. Eight patients still suffered from systolic pressure difference (5-20 mmHg), but had no need of reoperation. One patient suffered from anastomotic recoarctation 2 years and 3 months after operation and the pressure difference was 48 mmHg. After exerting balloon dilatation, the pressure difference reduced to 17 mmHg. Conclusions Surgery is an effective method of COA treatment. The surgical strategies should be selected according to the characters of coarctation lesions, intracardiac malformations, and the age of patient. Key words: Aortic coarctation/SU