Strategy of repairing coarctation of aorta with hypoplastic aortic arch using cardiopulmonary bypass in neonates

Abstract

Objective To analysis the the strategy of repairing coarctation of aorta with hypoplastic aortic arch in neonate. Methods Collected consecutive 24 neonates suffered coarctation of aorta with hypoplastic aortic arch form January 2015 to March 2017, 12 patients were underwent aortic arch reconstruction with extremely extended end-to-end anastomosis under cardiopulmonary bypass(CPB) through the media sternotomy approach(CPB group), while another 12 cases were under coarctation repair using end-to-end anastomosis or end-to-side anastomosis through left posterolateral thoracotomy approach(control group). The postoperative blood pressure, echocardiography and cardiac CT scan were used to evaluate the result of the aortic arch rconstruction.The pressuregradientof the upper limb and lower limb, flow velocity of the anastomoses, aortic arch morphology, rate of the residual abstruction were compared between the two groups. Results Mechanical ventilation time[ CPB group(17±27)h vs. control group(44±52)h, P 0.05]. There was no died in two gruops. Conclusion Anastomosis with end to end techinique under cardiopulmonary bypass may achieve better effect in neonates with coarctation of aorta with hypoplastic aortic arch, it has better duplcity, operability and early curative effect, but the long-term effect need the multicenter and large sample-volume study to explore. Key words: Coarctation of aorta; Cardiopulmonary bypass; Hypoplastic aortic arch; Neonate