Single-stage repair for coarctation with ventricular septal defect: results of 100 cases at a single centre

Thinh, Truong Nguyen Ly; Tuan, Nguyen Si; Vinh, Trần Quang; Anh, Doan Vuong; Duyen, Mai Dinh

doi:10.1093/icvts/ivaa148

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…The core temperature was decreased to 28°C during dissection, and near‐infrared spectroscopy was used to monitor all patients. In cases in which coarctation or aortic arch reconstruction was required, the aortic cannula was advanced into the innominate artery, and antegrade cerebral perfusion was performed with the surgical technique for aortic arch reconstruction, as previously described 11 . The closed technique for coronary transfer was used in all patients 12 .…”

Section: Methodsmentioning

confidence: 99%

Results of the arterial switch operation for Taussig–Bing variants in the setting of a lower‐middle income country: A single‐institution experience

Nguyen¹,

Nguyen²,

Trần³

et al. 2022

Journal of Cardiac Surgery

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Background This study was conducted to evaluate the surgical results of the arterial switch operation for Taussig‐Bing variants, at a single institution in a lower‐middle income country. Methods Between June 2010 and December 2018, all consecutive patients diagnosed with Taussig‐Bing variants who underwent the arterial switch operation and ventricular septal defect closure were included in the study. Results A total of 72 patients of Taussig‐Bing variants underwent arterial switch operation and ventricular septal defect closure. There were 10 early deaths (13.9%) and 2 late deaths (2.8%). Intraoperative ventricular septal defect enlargement (hazard ratio [HR] 7.23, 95% confidence interval [CI] 3.1294–16.7167; p < .001), secondary aortic cross‐clamping (HR 28.38, 95% CI 4.8427–166.3484; p < .001), postoperative pneumonia (HR 5.64, 95% CI 1.2724–24.9917; p = .023), and postoperative sepsis (HR 5.28, 95% CI 1.3512–20.6553; p = .017) were risk factors for overall mortality by competing risk analysis. Sixty patients (83.3%) required septoparietal trabeculation division/resection during the arterial switch operation in an attempt to avoid right ventricular outflow tract obstruction. The reoperation rate for right ventricular outflow tract obstruction at last follow up was 6% (three patients). The estimated freedom from reoperation for right ventricular outflow tract obstruction at 1, 5, and 9 years was 98.3%, 91.9%, and 91.9%, respectively. Conclusions The results of arterial switch operation for Taussig‐Bing variants were satisfactory in the operative setting of a lower‐middle income country, and performing extensive septoparietal trabeculation division might reduce the reintervention rate for right ventricular outflow tract obstruction in these patients.

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Section: Methodsmentioning

confidence: 99%

Results of the arterial switch operation for Taussig–Bing variants in the setting of a lower‐middle income country: A single‐institution experience

Nguyen¹,

Nguyen²,

Trần³

et al. 2022

Journal of Cardiac Surgery

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“…Several techniques of aortic arch repair for CoA/HAA as the single-stage repair via median sternotomy have been reported. 16,17 Ascending sliding arch aortoplasty allows anatomical repair, avoids the use of patch material, and restores a normal arch contour.…”

Section: Commentmentioning

confidence: 99%

Long-Term Outcomes of Ascending Sliding Arch Aortoplasty

Yoneyama,

Kalustian,

McKenzie

et al. 2024

World J Pediatr Congenit Heart Surg

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Background: Coarctation of the aorta can be associated with significant hypoplasia of the aortic arch. In contrast to patch aortoplasty, ascending sliding arch aortoplasty uses viable autologous tissue for potential growth in children. We reviewed the mid- to long-term outcomes of this technique. Methods: Between 2002 and 2023, 28 patients underwent ascending sliding arch aortoplasty for the patients with coarctation of the aorta (n = 22) and interrupted aortic arch (n = 2). Four patients underwent previous surgical coarctation repair at other institutions. The median patient age and body weight were 28.5 months (3 weeks to 15.6 years) and 13.4 kg (3.7-70 kg), respectively. Results: Although one patient had a recurrent nerve injury postoperatively, there were no other major morbidities or mortalities. The last follow-up echocardiography demonstrated that the mean peak velocity improved from 3.9 ± 0.6 to 0.9 ± 0.8 m/s, and the pressure gradient improved from 63.6 ± 21.5 to 7.1 ± 7.7 mm Hg. The postoperative diameters of the ascending aorta, proximal arch, distal arch, and isthmus all increased significantly. The mean postoperative length of stay was 5.9 ± 2.1 days, and the median follow-up time was 7.3 years (10 days to 20.5 years). No reoperation or catheterization-based intervention was performed for residual coarctation. Conclusions: Ascending sliding arch aortoplasty is safe and effective for treating coarctation of the aorta with aortic arch hypoplasia. This technique is applicable for children ranging in size from neonates to older children (or adolescents), recurrent coarctation cases, and provides complete relief of narrowing by utilizing viable native aortic tissue.

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15-Year Analysis of Surgical Approaches and Outcomes for Coarctation in 132 Neonates and Infants

Stukov,

Jacobs,

Sharaf

et al. 2024

Pediatr Cardiol

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Background: A variety of surgical approaches exist to treat aortic coarctation in neonates and infants.Our institutional approach is designed to match the surgical approach to the individual anatomy of the patient. The objective of this study is to evaluate operative characteristics and outcomes of all neonates and infants undergoing surgical repair of aortic coarctation or hypoplastic aortic arch.Methods: Retrospective review of 132 patients aged 0-1 year who underwent surgical repair of coarctation or hypoplastic aortic arch between 2006 and 2021, inclusive, either in isolation or with concomitant repair of atrial septal defect (ASD) and/or ventricular septal defect (VSD). Patients were divided into two groups based on the surgical approach: Group 1 = Median Sternotomy and Group 2 = Left Lateral Thoracotomy. Continuous variables are presented as median (minimum-maximum); categorical variables are presented as N (%).Results: The most common operative technique in Group 1 was end-to-side reconstruction with ligation of the aortic isthmus. The most common operative technique in Group 2 was extended end-to-end repair.Operative Mortality was one patient (1/132 = 0.76%). Transcatheter intervention for recurrent coarctation was performed in seven patients (7/132 = 5.3%). Surgical re-intervention for recurrent coarctation was performed in three patients (3/132 = 2.3%).Conclusions: A strategy of matching the surgical approach to the anatomy for neonates and infants undergoing surgical repair of coarctation or hypoplastic aortic arch, either in isolation or with concomitant repair of ASD and/or VSD, is associated with <1% Operative Mortality and <3% recurrent coarctation requiring reoperation.

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Single-stage repair for coarctation with ventricular septal defect: results of 100 cases at a single centre

Cited by 6 publications

References 16 publications

Results of the arterial switch operation for Taussig–Bing variants in the setting of a lower‐middle income country: A single‐institution experience

Results of the arterial switch operation for Taussig–Bing variants in the setting of a lower‐middle income country: A single‐institution experience

Long-Term Outcomes of Ascending Sliding Arch Aortoplasty

15-Year Analysis of Surgical Approaches and Outcomes for Coarctation in 132 Neonates and Infants

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