Coarctation of the Aorta in Infants: Which Operation?

Trinquet, Françoise; Vouhé, Pascal; Vernant, Françoise; Touati, Gilles; Roux, Pierre-Michel; Pomè, Giuseppe; Leca, F; Neveux, Jean-Yves

doi:10.1016/s0003-4975(10)62434-4

Cited by 51 publications

(21 citation statements)

References 17 publications

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“…42 Certain factors are associated with worse outcomes from congenital heart defects, including the type and complexity of the malformation, associated extracardiac anomalies and congestive heart failure. [203][204][205][206][207][208][209][210][211] Children born with congenital heart defects have a higher incidence of neurological abnormalities, including microcephaly, hypotonia, hypertonia, seizures, feeding difficulties and lethargy in the newborn period, 173,175 and these do not appear to be predicted by difficulties at birth, such as birth asphyxia. 164,166,212 Preoperative cerebral infarctions have been noted in 4% of children with congenital heart defects and are associated with subsequent abnormal neurological development.…”

Section: Antenatal and Perinatal Factorsmentioning

confidence: 99%

“…82,105,216 Many studies find that a younger age at surgery is associated with higher perioperative mortality, but the need for early surgery is often confounded with severity. 82 Other studies have found that a young age at surgery predicts better survival for malformations in which preoperative collapse is a feature, including TGA, truncus and PA. 204 Metabolic acidosis or the need for ventilatory support in the period before surgery is predictive of poorer operative survival [80][81][82][83]211,221 and increased incidence of neurodevelopmental (particularly speech and motor) sequelae in the long term. 164,176 Reduction in preoperative acidosis through antenatal screening has been demonstrated for several defects, including HLH and TGA.…”

Section: Preoperative Collapse and Other Factorsmentioning

confidence: 99%

“…22,80,82,83,105,204,211,221,227 For the purposes of the decision model, we assumed the primary outcome measure of newborn screening to be a timely diagnosis in these 'life-threatening' defects.…”

Section: Primary Outcomementioning

confidence: 99%

See 2 more Smart Citations

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Knowles¹,

Griebsch²,

Dezateux

et al. 2005

Health Technol Assess

214

143

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Section: Antenatal and Perinatal Factorsmentioning

confidence: 99%

Section: Preoperative Collapse and Other Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Knowles¹,

Griebsch²,

Dezateux

et al. 2005

Health Technol Assess

214

143

View full text Add to dashboard Cite

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“…Several studies in the literature have also compared freedom from re-stenosis requiring intervention in patients undergoing SFA versus EEA, and have found similar outcomes at 5 years. A freedom from re-stenosis in SFA patients of 87-89% at 5 years versus 86-95% in the EEA patients has been reported [12,13].…”

Section: Discussionmentioning

confidence: 99%

Subclavian flap aortoplasty: still a safe, reproducible, and effective treatment for infant coarctation

Barreiro

Ellison

Williams

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…Thus, we tend to avoid such procedures, unless the repair techniques are superior to end-to-end anastomosis in terms of postoperative morbidity and mortality, which is highly unlikely. [24][25][26][27] Hemodynamic stability during aortic arch repair is mandatory for extensive circumferential dissection and cross-clamping of the aorta, and also for reduction in the development of residual or recurrent coarctation. Intraoperative pharmacologic intervention including prostaglandin E 1 and exogenous catecholamines play a critically important role.…”

Section: Discussionmentioning

confidence: 99%

Complications following reparative surgery for aortic coarctation or interrupted aortic arch

et al. 1998

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Repair of aortic coarctation or interrupted aortic arch continues to be associated with major long-term morbidity. Thus, we conducted a review of 87 consecutive patients who underwent aortic arch repairs, focusing particular attention on the complications that developed. A two-stage strategy was employed if cardiac lesions were associated. The median age at surgery was 1.5 months with a range of 12 h to 56 years. The aortic arch was repaired using end-to-end anastomosis, subclavian flap aortoplasty, subclavian arterial turning-down aortoplasty, patch aortoplasty, tube graft interposition, or other methods. There were 10 patients who died soon after repair, and all of whom had complex cardiac anomalies. Of the remaining 77 patients, 8 developed recurrent stenosis. These 8 patients were all similar in age, being under 3 months old, and weighing 4 kg or less. A multivariable analysis of the infants identified interrupted aortic arch as an independent risk factor for the development of this complication with an odds ratio of 6.45. Complications following prosthesis-free techniques were similar in prevalence and timing. All reinterventions were mortality-free, but catheter dilation and patch aortoplasty were not always successful. Three extraanatomic bypasses were successfully performed, and one adult who had undergone a previous graft and pseudoaneurysm operation was successfully treated with an extraanatomic bypass. These findings led us to conclude that the initial repair should be performed without a prosthesis, and that reintervention for stenosis should combine catheter dilation and extraanatomic bypass.

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Coarctation of the Aorta in Infants: Which Operation?

Cited by 51 publications

References 17 publications

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Subclavian flap aortoplasty: still a safe, reproducible, and effective treatment for infant coarctation

Complications following reparative surgery for aortic coarctation or interrupted aortic arch

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