Distal Aortic Arch Hypoplasia and Coarctation Repair: A Tailored Enlargement Technique

Poncelet, Alain; Henkens, Arnaud; Sluysmans, Thierry; Moniotte, Stéphane; Beco, Geoffroy de; Momeni, Mona; Detaille, Thierry; Rubay, Jean

doi:10.1177/2150135118780611

Cited by 9 publications

(11 citation statements)

References 27 publications

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“…Backer and Mavroudis described isthmus hypoplasia as the condition wherein the isthmus is less than 40% of the diameter of the ascending aorta and when arch hypoplasia as proximal or distal transverse arch is less than 60% or 50% of the diameter of the ascending aorta, respectively, in "Congenital Heart Surgery Nomenclature and Database Project" (7) . Poncelet et al used Z-scores and defined distal arch hypoplasia with a Z-score of less than -3 in their study (3) . An echocardiographic measurement formula "transvers arcus diameter divided to descending aorta diameter" was recommended by Rao et al, and a ratio of less than 0.65 was suggested to be significant (9) .…”

Section: Discussionmentioning

confidence: 99%

“…Anatomic spectrum can vary from a mild isolated CoA to severe hypoplasia of the left heart structures (2) . Although a vast majority of cases have only shown an isolated ventricular septal defect (VSD), several more complex congenital intracardiac anomalies may include double outlet right ventricle, transposition of great arteries, atrioventricular septal defect, univentricular heart, and so on (1)(2)(3) . An early treatment may be needed because of the severity of hypoplasia and/or associated intracardiac defects.…”

Section: Introductionmentioning

confidence: 99%

“…An early treatment may be needed because of the severity of hypoplasia and/or associated intracardiac defects. Several surgical techniques have been presented in the literature; however, patch aortoplasty and extended end-to-end anastomosis (EEEA) are the most commonly used techniques (1,(3)(4)(5) . However, even with better surgical techniques for the neonates, additional structural anomalies or comorbidities such as the development of restenosis at the site of aortic anastomosis, left ventricular outflow tract obstruction, and left bronchial compression are still some risk factors for worse outcomes (4) .…”

Section: Introductionmentioning

confidence: 99%

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Arcus Aorta Reconstructions in Neonates and Early Infants

Yildirim

Suzan

2020

Kosuyolu Heart Journal

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Introduction: Various instances of aortic arch hypoplasia (AAH) with a wide spectrum of severity have been observed in the neonatal patients. The purpose of this paper is to discuss the aortic arch reconstruction in the coarctation of the aorta and AAH while focusing on the surgical decisions and patient management for the neonatal and infant patients. Patients and Methods:We performed a retrospective review of 15 patients who underwent aortic arch reconstruction. Importantly, we investigated postoperative outcomes with associated complex congenital heart diseases. Results:The median age and mean weight of the patients were 74 days (range: 4-306 days) and 4192 ± 1253 gram, respectively. The surgical correction of aortic arch congenital abnormalities was performed under selective antegrade cerebral perfusion in all the 15 patients. All the reconstructions were performed with pericardial patch, and the coarcted segment of the aorta was completely resected in seven of the patients. One-stage repair was performed in the seven of the patients. The mean follow-up time was 13.7 ± 9.3 months. In one patient, transcatheter balloon angioplasty was performed for re-coarctation six months after operation. There was one early and one late mortality. Conclusion:Aortic arch reconstruction can be performed with a low mortality and morbidity in the newborn and infants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Arcus Aorta Reconstructions in Neonates and Early Infants

Yildirim

Suzan

2020

Kosuyolu Heart Journal

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“…The technical details of the repair combining carotid-subclavian angioplasty and extended end-to-end anastomosis were described previously. 5…”

Section: Methodsmentioning

confidence: 99%

“…We recently reported our experience with a modified approach to the carotid-subclavian angioplasty described by Amato et al 4 in a subgroup of patients with distal arch hypoplasia. 5…”

Section: Introductionmentioning

confidence: 99%

Results of Coarctation Repair by Thoracotomy in Pediatric Patients: A Single Institution Experience

Heremans

Henkens

Beco

et al. 2021

World J Pediatr Congenit Heart Surg

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Background: Aortic coarctation is among the most common cardiovascular congenital abnormalities requiring repair after birth. Besides mortality, morbidity remains an important aspect. Accordingly, we reviewed our 20-year experience of aortic coarctation repair by thoracotomy, with emphasis on both short- and long-term outcomes. Methods: From 1995 through 2014, 214 patients underwent coarctation repair via left thoracotomy. Associated arch lesions were distal arch hypoplasia (n = 117) or type A interrupted aortic arch (n = 6). Eighty-four patients had isolated coarctation (group 1), 66 associated ventricular septal defect (group 2), and 64 associated complex cardiac lesions (group 3). Median follow-up was 8.4 years. Results: There was one (0.5%) procedure-related death. Nine (4.2%) patients died during index admission. In-hospital mortality was 0.7% in group 1 and 2 and 12.5% in group 3 ( P < .001). No patient had paraplegia. Actuarial five-year survival was 97.5% in group 1, 94% group 2 and 66% in group 3. Recurrent coarctation developed in 29 patients, all but four (1.8%) successfully treated by balloon dilatation. Freedom from reintervention (dilatation or surgery) at five years was 86%. At hospital discharge, 28 (13.5%) patients were hypertensive. At follow-up, hypertension was present in 11 (5.3%) patients. Conclusions: Long-term results of aortic coarctation repair by thoracotomy are excellent, with percutaneous angioplasty being the procedure of choice for recurrences. Patient prognosis is dependent on associated cardiac malformations. In this study, the prevalence of late arterial hypertension was lower than previously reported.

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Role of Cardiac CT in Preopertaive and Postoperative Evaluation of Congenital Heart Defects in Children

Corno

Salazar

2021

Pediatric Cardiac CT in Congenital Heart Disease

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Distal Aortic Arch Hypoplasia and Coarctation Repair: A Tailored Enlargement Technique

Cited by 9 publications

References 27 publications

Arcus Aorta Reconstructions in Neonates and Early Infants

Arcus Aorta Reconstructions in Neonates and Early Infants

Results of Coarctation Repair by Thoracotomy in Pediatric Patients: A Single Institution Experience

Role of Cardiac CT in Preopertaive and Postoperative Evaluation of Congenital Heart Defects in Children

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