Effect of stage 1 repair of coarctation of aorta combined with cardiac anomalies and analysis of median follow-up finding

Abstract

Objective To summarize the outcomes and the median follow-up finding of stage 1 surgical approaches of coarctation of aorta(CoA) combined with cardiac anomalies. Methods A retrospective study was performed for summarizing the operative and follow-up finding of 82 patients(40 males and 42 females) of CoA combined with cardiac anomalies, who underwent stage 1 repair from February 2013 to December 2016 at the Department of Cardio-vascular Surgery, Henan Provincial People′s Hospital.The operative age was ranged from 1 month to 8 years old[mean (11.92±22.51) months] and the weight was (7.31±6.79) kg.Forty-five cases had ventricular septal defect (VSD) or atrial septal defect (ASD). Septal defect and patent ductus arteriosus were found in 31 patients.CoA was associated with aortic arch hypoplasia in 5 patients.Complex cardiovascular deformity was found in 7 cases.The surgical methods included end-to-end anastomosis, end-to-side anastomosis and patch augmentation of the coarctation segment. Results Seven patients died after operation, 3 cases of them died of low cardiac output syndrome amd circulatory failure, 1 case died of circulatory failure and respiratory failure, 1 patient died of malignant arrhythmia, and 2 cases died of respiratory failure.Postoperative echocardiogram suggested that anastomosis maintained patency in all the patients.The follow-up time was 8 months to 4 years, 63 patients were followed up, and follow-up rate was 77%.No death or aneurysm occurred during follow-up period.Recoarctation was found in 5 cases. Conclusions Stage 1 repair for CoA combined with cardiac anomalies is effective, and has low complications during postoperative and median follow-up period.Long-term results need further study. Key words: Congenital heart disease; Coarctation of aorta; Stage 1 surgical therapy