Aortic Coarctation/Arch Hypoplasia Repair: How Small Is Too Small

Tsang, Victor; Haapanen, Henri; Neijenhuis, Ralph M. L.

doi:10.1053/j.pcsu.2019.02.011

Cited by 25 publications

(15 citation statements)

References 28 publications

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“…One more approach to treat patients with tubular arch or moderate or severe proximal arch hypoplasia and without contraindications for CPB is “Norwood type” reconstruction. This method is carried out through median sternotomy with homograft patch for inner curve of the arch 19 . This type of repair is a method of choice for cases with intracardiac defects that required surgery.…”

Section: Discussionmentioning

confidence: 99%

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Modified technique for coarctation of aorta with hypoplastic distal aortic arch

et al. 2021

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Background A combination of coarctation of aorta with various severity of distal arch hypoplasia frequently occurs in newborns. Traditional techniques in the neonatal period such as extended end‐to‐end anastomosis or inner curve patch are controversial. Arch geometry has a marked role in long‐term outcomes. We introduce a modified Amato technique of distal aortic arch enlargement with native tissue‐to‐tissue reconstruction. Methods Neonatal patients with coarctation of aorta and distal aortic arch hypoplasia who underwent surgical reconstruction using this technique between January 2016 and December 2019 in our center were included. Patients with concomitant complex heart defects were excluded. Data were obtained from echo protocols, CT scans before and after repair. The dimensions of the arch were assessed using Z‐score, arch geometry was evaluated with height/width ratio. Results Thirty‐two patients (22 males, 10 females) were included. Median age and weight were 7 days (5; 18) and 3.5 kg (3.1; 4.0), respectively. The Z‐score of distal part of the arch before and after procedure was significantly different (<0.01). No mortality, recoarctation, or bronchial compression was found during 18 (6–38) months of follow‐up. Conclusion Modified technique for coarctation of aorta with hypoplastic distal aortic arch provides favorable geometry of the aorta with a low risk of morbidity. The proper selection and accurate technique could minimize potential risks. This method is relatively safe and might improve long‐term outcomes associated with the geometry of aorta.

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Section: Discussionmentioning

confidence: 99%

“…This method is carried out through median sternotomy with homograft patch for inner curve of the arch. 19 This type of repair is a method of choice for cases with intracardiac defects that required surgery.…”

Section: Discussionmentioning

confidence: 99%

Modified technique for coarctation of aorta with hypoplastic distal aortic arch

et al. 2021

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Coarctation of the aorta accounts for 5% to 8% of congenital heart disease, and is often identified and treated during childhood ( 1 ). Primary surgical repair of coarctation can be associated with long-term issues such as recurrent coarctation, occurring in 5% to 24% of patients, and late hypertension despite repair ( 1 ). Aortic aneurysm and pseudoaneurysm occur in 5% to 10% of patients undergoing coarctation repair and have been reported after every type of coarctation repair (end-to-end, subclavian flap, prosthesis interposition, and patch aortoplasty) ( 2 , 3 ).…”

Section: Discussionmentioning

confidence: 99%

CT—Guided Endovascular Exclusion of Pseudoaneurysmal Subclavian Bypass After Early-Age Surgical Correction of Complex Aortic Coarctation

Nihum

Chinnadurai³

et al. 2021

JACC: Case Reports

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We describe a 64-year-old woman with subclavian pseudoaneurysm after aortic coarctation repair, treated using a hybrid approach involving true three-dimensional analysis and image fusion-guided placement of thoracic endovascular aortic repair stents. This case illustrates the potential complications of coarctation repair and need for lifelong surveillance in these patients. ( Level of Difficulty: Advanced. )

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“…Devido a sua origem histológica de anormalidade da parede arterial, a CoA é considerada uma arteriopatia generalizada, sendo assim, associada às patologias cardiovasculares de longa duração. O estreitamento causado pela doença geralmente está localizado na origem da artéria subclávia esquerda, justaductalmente à inserção do ducto arterioso patente, podendo, em casos mais raros, apresentar-se ectopicamente (ascendente, descendente ou aorta abdominal) (TSANG;HAAPANEN;NEIJENHUIS;2019).…”

Section: Introductionunclassified

Relato De Caso: Coarctação De Aorta Em Puérpera

LUZ¹,

CAVALHEIRO²,

FOLETTO³

et al. 2021

Anais Da VII Jornada Internacional De Enfermagem, Edição 2021

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A coarctação da aorta (CoA) é uma das anomalias cardíacas congênitas mais comuns, frequentemente associada a outros defeitos cardíacos congênitos. Embora essa patologia seja identificada geralmente no período neonatal/infantil, ainda há muitos jovens e adultos assintomáticos, os quais acabam subdiagnosticados. O principal achado no exame físico é a hipertensão dos membros superiores e, por esse motivo, a CoA deve ser considerada em qualquer jovem hipertenso, justificando a medição da pressão arterial dos membros inferiores pelo menos uma vez nesses pacientes. O diagnóstico precoce, principalmente através do ecocardiograma, e o tratamento adequado são de extrema importância, haja vista que os pacientes com CoA têm risco aumentado para complicações cardiovasculares e menor expectativa de vida comparados a população em geral. Mesmo após o reparo corretivo da CoA, seja por abordagem cirúrgica ou endovascular, o acompanhamento periódico do paciente é essencial para identificar possíveis complicações a longo prazo. Em mulheres com CoA, seja ela reparada ou não, a gravidez aumenta o risco de aneurismas, dissecção aórtica, hipertensão materna, pré-eclâmpsia e parto prematuro. O controle da pressão arterial é um aspecto imprescindível no manejo da gravidez em mulheres com CoA.Palavras-chave: coarctação da aorta; diagnóstico precoce; coarctação da aorta em adultos; coarctação da aorta e gravidez.

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Aortic Coarctation/Arch Hypoplasia Repair: How Small Is Too Small

Cited by 25 publications

References 28 publications

Modified technique for coarctation of aorta with hypoplastic distal aortic arch

Modified technique for coarctation of aorta with hypoplastic distal aortic arch

CT—Guided Endovascular Exclusion of Pseudoaneurysmal Subclavian Bypass After Early-Age Surgical Correction of Complex Aortic Coarctation

Relato De Caso: Coarctação De Aorta Em Puérpera

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