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主动脉缩窄患儿的评估:单中心经验

Evaluation of Children with Aortic Coarctation: A Single-Center Experience.

作者信息

Türkmen Hasan, Uysal Fahrettin, Genç Abdüsselam, Bostan Özlem M, Şenkaya Siğnak Işık

机构信息

Department of Pediatric Cardiology, Faculty of Medicine, Bursa Uludag University, Bursa, Türkiye.

Department of Pediatric Cardiovascular Surgery, Faculty of Medicine, Bursa Uludag University, Bursa, Türkiye.

出版信息

Turk Arch Pediatr. 2024 Sep 2;59(5):480-487. doi: 10.5152/TurkArchPediatr.2024.24050.

Abstract

Coarctation of the aorta (CoA) accounts for 3.5% of all congenital heart diseases in children. The clinical manifestations range from heart failure to asymptomatic hypertension. Treatment options include surgical repair, balloon angioplasty, and stenting. We aimed to investigate the long-term results of surgery and balloon angioplasty to identify the possible risk factors for recoarctation and predictors associated with early success in treatment modalities. The data of 138 children who underwent examinations at a tertiary center between 2015 and 2020 with the diagnosis of CoA were evaluated. The basic demographic characteristics, clinical and echocardiographic findings, results, and treatment methods of the patients were evaluated retrospectively. The mean follow-up period was 75.1 months (range of 1-223). As initial treatment, 75 patients (60.5%) underwent balloon angioplasty, 44 (35.5%) underwent surgery, and 5 (4%) underwent stenting. The early success rate of balloon angioplasty and surgery was 72.5% and 79.5%, respectively. Recoarctation occurred in 47.6% of patients following the first therapy. The median reintervention-free survival time was 138 months for all patients and was significantly higher in the surgery group (P = .025). The recoarctation rate was slightly lower in the surgery group than in those who underwent balloon angioplasty, but it was not statistically significant. None of the clinical and echocardiographic findings were found to be associated with recoarctation or early success. The rate of recoarctation is still high in long-term follow-up after aortic coarctation treatment, and clinical and echocardiographic findings are insufficient to predict the chance of early success and the risk of recoarctation.

摘要

主动脉缩窄(CoA)占儿童先天性心脏病的3.5%。临床表现从心力衰竭到无症状高血压不等。治疗选择包括手术修复、球囊血管成形术和支架置入术。我们旨在研究手术和球囊血管成形术的长期结果,以确定再缩窄的可能危险因素以及与治疗方式早期成功相关的预测因素。对2015年至2020年在一家三级中心接受检查并诊断为CoA的138名儿童的数据进行了评估。回顾性评估了患者的基本人口统计学特征、临床和超声心动图检查结果、治疗结果及治疗方法。平均随访期为75.1个月(范围1 - 223个月)。作为初始治疗,75例患者(60.5%)接受了球囊血管成形术,44例(35.5%)接受了手术,5例(4%)接受了支架置入术。球囊血管成形术和手术的早期成功率分别为72.5%和79.5%。首次治疗后47.6%的患者发生了再缩窄。所有患者无再次干预的中位生存时间为138个月,手术组显著更长(P = 0.025)。手术组的再缩窄率略低于接受球囊血管成形术的患者,但无统计学意义。未发现任何临床和超声心动图检查结果与再缩窄或早期成功相关。主动脉缩窄治疗后的长期随访中,再缩窄率仍然很高,临床和超声心动图检查结果不足以预测早期成功的机会和再缩窄的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3496/11391242/7ab5a8bf2e5c/tap-59-5-480_f001.jpg

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