Short-Term Outcomes of Two Surgical Techniques for the Treatment of Coarctation of the Aorta in Infants: Subclavian Flap Repair and Resection with Extended End-to-End Anastomosis Technique

Mustafa Karaçelik,Pelin Ozturk,Eyüp Hazan,Burçin Abud,Koray Aykut,Onur Doyurgan,Mehmet Güzeloğlu,Uğur Karagöz,Osman Nejat Sarıosmanoğlu,Gökhan Albayrak

doi:10.4236/wjcd.2015.51001

Mustafa Karaçelik, Pelin Ozturk + Show 8 more

Open Access

https://doi.org/10.4236/wjcd.2015.51001

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Abstract

Background: The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. Methods: Outcomes of two different surgical repairs for coarctation of the aorta in 43 infants were evaluated retrospectively. The study was designed as a nonrandomized, cross-sectional study. The subclavian flap repair was applied to 22 patients (51%) and resection with extended end-to-end anastomosis technique to 21 patients (49%). After all operative survivors were followed up with a mean follow-up of 1.8 ± 0.8 years, data analyzed with t-test and the p value < 0.05 were considered statistically significant. Results: The overall mortality rate was 4.6%. Forty mmHg gradients were determined in a patient from Resection Group postoperatively in the fifteenth month. After the balloon angioplasty, the gradient decreased to 25 mmHg. The presence of ventricular septal defect (p = 0.094) was the only significant predictor of adverse short-term outcome among the associated cardiac defects analyzed. The first-year survival rate was 100% in both groups in isolated coarctation (p = 0.965), however; such rate was found as 100% and 93.25% in Waldhausen Group and Resection Group, respectively in complex coarctation (p = 0.294). Conclusions: Both the subclavian flap repair and resection with extended end-to-end anastomosis for coarctation of the aorta in infants provide excellent short-term outcomes with lower recurrence rates requiring surgery or angioplasty.

Highlights

The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers
Surgical procedures such as; resection with end-to-end anastomosis, patch aortoplasty, left subclavian flap angioplasty, bypass graft repair were reported in the surgical treatment of aortic coarctation
The most used technique is resection with extended end-to-end anastomosis procedure, but there is no exact data that this procedure is superior to others [2]

Summary

Introduction

The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. The aortic coarctation ought to be treated in children during the infancy period [1] Surgical procedures such as; resection with end-to-end anastomosis, patch aortoplasty, left subclavian flap angioplasty, bypass graft repair were reported in the surgical treatment of aortic coarctation. Cobanoglu et al [3] compared the results of the end-toend repair group with the results of the subclavian flap angioplasty group and found no difference between the groups. They said that, concomitant diagnosis of ventricular septal defect significantly increased the mortality rate of coarctation repair by approximately two times. Aims of our study were to evaluate the results of two surgical procedures, and to find out the specific predictors of short-term result, after repair of aortic coarctation in infants and prematurely born infants

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