Egunov Oleg A, Krivoshchekov Evgeny V, Cetta Frank, Sokolov Alexander A, Sviazov Evgenii A, Shipulin Vladimir V
Department of Cardiovascular Surgery , Cardiology Research Institute, Tomsk National Research Medical Center, Tomsk, Russia.
Department of Cardiovascular Diseases, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
J Card Surg. 2022 Jun;37(6):1627-1632. doi: 10.1111/jocs.16435. Epub 2022 Mar 21.
Persistence or recurrence of stenosis is a complication of initial coarctation repair. This study aims to report short-term outcomes of surgical management of recurrent coarctation and initial repair analysis.
We retrospectively reviewed our experience with 51 patients undergoing recoarctation surgical repair between 2008 and 2019 using antegrade cerebral perfusion (ACP) technique.
Surgical correction included prosthetic patch aortoplasty in 23 (45%), resection with wide end-to-end anastomosis in 15 (29%), and a tube interposition graft in 13 (25%) patients. The median age at initial correction and reintervention was 12 months and 9 years. The median interval from primary repair to reintervention was 60 months. Initial repair analysis revealed 33% of patients had initial correction in the neonatal period, 72.5% of patients were done via a left thoracotomy approach and 63% of patients had end-to-end anastomosis at initial surgery.
Our study demonstrates that surgical repair of recurrent coarctation of the aorta using ACP technique can be performed safely and with excellent results.
狭窄的持续存在或复发是初次主动脉缩窄修复术的一种并发症。本研究旨在报告复发性主动脉缩窄手术治疗的短期结果及初次修复分析。
我们回顾性分析了2008年至2019年间51例行顺行性脑灌注（ACP）技术复发性主动脉缩窄手术修复患者的经验。
手术矫正包括23例（45%）患者行人工补片主动脉成形术，15例（29%）患者行广泛端端吻合切除，13例（25%）患者行管状移植术。初次矫正和再次干预的中位年龄分别为12个月和9岁。从初次修复到再次干预的中位间隔时间为60个月。初次修复分析显示，33%的患者在新生儿期进行了初次矫正，72.5%的患者通过左胸切口入路进行手术，63%的患者在初次手术时进行了端端吻合。
我们的研究表明，使用ACP技术对复发性主动脉缩窄进行手术修复可以安全进行，且效果良好。
