Aortic Coarctation Associated with Distal Aortic Arch Hypoplasia in Neonates Can Be Effectively Repaired through Left Thoracotomy Article Swipe
Bastien Provost
,
Emmanuelle Fournier
,
Sébastien Hascoët
,
Emmanuel Le Bret
,
Régine Roussin
,
Joy Zoghbi
,
Emré Belli
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1155/2023/5599161
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1155/2023/5599161
Objectives. Aortic coarctation in neonates remains a clinical challenge. Low weight, arch hypoplasia and ductal dependence have been identified as risk factors for recurrent coarctation. We hypothesized that a tailored surgical technique may prevent recurrence. Methods. Retrospective evaluation of neonates treated for coarctation through thoracotomy was done. No primary percutaneous procedure was performed and repairs through sternotomy were excluded. Aortic hypoplasia was defined as a ratio arch diameter (mm)/patient’s weight (kg) < 1. Extended end-to-end anastomosis (EEEA), subclavian flap (Waldhausen) and Amato aortoplasty were performed. Mortality and recurrent obstruction requiring re-intervention were assessed. Results. Records of 340 consecutive patients (2003–2019) were analyzed. Preoperative median age and weight were, respectively, 10 days (1–30) and 3080 grams (1400–5180). Arch hypoplasia was documented in 31 patients (9.1%). Prostaglandin was infused in 220 (65.3%). Critical preoperative status was documented in 35 (10.8%). EEEA repair was performed in 273 (80.3%), Waldhausen was performed in 42 (12.4%), and Amato was performed in 25 (7.4%). The last two were more likely to be performed in the presence of arch hypoplasia ( p < 0.0001). Hospital mortality occurred in 2 patients (0.6%). Thirty-six procedures (31 percutaneous/5 surgical) were performed for recurrent arch obstruction in 33 patients. Three late deaths occurred. Low-weight, hypoplastic arch, and ductal dependency did not influence the outcome. All survivors were free from residual coarctation at a mean follow-up of 3.6 ± 3.4 years postoperatively. Conclusions. Surgical repair remains the procedure of choice for neonatal coarctation. A tailored approach using alternative techniques seemed to offer comparable results even in presence of associated risk factors.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- http://doi.org/10.1155/2023/5599161
- https://downloads.hindawi.com/journals/jocs/2023/5599161.pdf
- OA Status
- hybrid
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4389426067
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4389426067Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1155/2023/5599161Digital Object Identifier
- Title
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Aortic Coarctation Associated with Distal Aortic Arch Hypoplasia in Neonates Can Be Effectively Repaired through Left ThoracotomyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-12-07Full publication date if available
- Authors
-
Bastien Provost, Emmanuelle Fournier, Sébastien Hascoët, Emmanuel Le Bret, Régine Roussin, Joy Zoghbi, Emré BelliList of authors in order
- Landing page
-
https://doi.org/10.1155/2023/5599161Publisher landing page
- PDF URL
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https://downloads.hindawi.com/journals/jocs/2023/5599161.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://downloads.hindawi.com/journals/jocs/2023/5599161.pdfDirect OA link when available
- Concepts
-
Medicine, Hypoplasia, Aortic arch, Surgery, Retrospective cohort study, Anastomosis, Thoracotomy, AortaTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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26Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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