Abstract
Objective To summarize the institutional experiences of surgical treatment for aortic coarctation and/or aortic hypoplasty associated with intracardiac anomalies in neonates. Methods The clinical data of 47 hospitalized cases with aortic coarctation and/or aortic hypoplasty between January 2010 and September 2016 were analyzed retrospectively. Expanded end-to-end anastomosis (n=15) and end-to-side anastomosis (n=32) were performed with a midline chest incision. Autologous or bovine pericardial patch was selected according to the intraoperative circumstances. Results Two intraoperative deaths occurred due to a serious low cardiac output syndrome in an early period. Among 3 postoperative deaths, the causes were a seriously low cardiac output syndrome plus failed rescue, postoperative withdrawal of long-term respiratory assistance leading to severe pulmonary infection and recurrent shortness of breath and choking cough. Chest computed tomography (CT) showed a collapse of left main bronchus and respiratory and circulatory failure. Three trachyphonic patients recovered basically after a follow-up period of 3 months. Forty-two patients were followed up for 6 months to 6 years. Three patients had significant upper-to-lower extremity systolic blood pressure gradient (>20 mmHg) and reoperation was proposed for 1 of them while another 2 were still under follow-up. Conclusions After a definite diagnosis, aortic coarctation and/or hypoplasty associated with intracardiac anomalies should be promptly and properly operated in neonates. Selective antegrade cerebral perfusion or deep hypothermic circulatory arrest is dependent upon a surgeon’s discretion. Both expanded end-to-end anastomosis and end-to-side anastomosis can achieve excellent outcomes. Key words: Infant, newborn; Aortic coarctation; Hypoplastic aortic arch
Published Version
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