The Fate of the Aorta after Coarctation Repair: Open Surgical Replacement of Descending Aorta in a High-Volume Unit
Abstract
:1. Introduction
2. Methods
2.1. Preoperative Diagnostics and Indication for Surgery
2.2. Surgical Technique
2.3. Data Curation and Follow-Up
2.4. Study Definitions
2.5. Statistical Analysis
3. Results
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | N = 25 |
---|---|
Sex (male) | 17 (68%) |
Age at operation (years) | 45.4 ± 12.8 |
BMI (kg/m²) | 25.6 ± 3.9 |
Marfan | 1 (4%) |
Arterial hypertension | 13 (52%) |
Hyperlipidemia | 2 (8%) |
Diabetes | 1 (4%) |
Coronary artery disease | 0 (0%) |
Chronic renal insufficiency | 1 (4%) |
Patient No. | Cardiovas. Comorbidities | Primary Preoperation [Age] | Secondary Preoperation [Age] | Tertiary Preoperation [Age] | Descending Replacement [Age] | Following Cardiovascular Operations |
---|---|---|---|---|---|---|
1 | BAV, asc. aneurysm | CoA repair (interposition graft) [19 y] | Aortic valve replacement [30 y] | 35 y | Composite replacement of the aortic valve an ascending aorta [37 y] | |
2 | None | CoA repair (patch plasty) [22 y] | 36 y | None | ||
3 | VSD, PDA | CoA repair (patch plasty), PDA ligation, pulmonary artery banding [0 y] | VSD closure (patch) + pulmonary debanding [2 y] | Futile balloon dilatation [18 y] | 18 y | None |
4 | None | CoA repair (interposition graft) [23 y] | 54 y | None | ||
5 | BAV | CoA repair (patch plasty [14 y] | 40 y | None | ||
6 | BAV | CoA repair (interposition graft) [22 y] | Aortic valve replacement [31 y] | 45 y | ||
7 | BAV, anomalous pulmonary venous connection, PDA | CoA repair (patch plasty), PDA ligation [10 y] | 38 y | None | ||
8 | None | CoA repair (patch plasty) [0 y] | 20 y | None | ||
9 | None | CoA repair (patch plasty) [26 y] | Aortic valve replacement [61 y] | Axillo-femoral bypass [63 y] | 63 y | None |
10 | BAV | CoA repair (patch plasty [19 y] | 36 y | None | ||
11 | None | CoA repair (patch plasty) [35 y] | 62 y | None | ||
12 | None | CoA repair (patch plasty) [14 y] | Aortic valve replacement [35 y] | 40 y | None | |
13 | None | CoA repair (patch plasty) [23 y] | 50 y | None | ||
14 | None | CoA repair (patch plasty) [13 y] | 42 y | None | ||
15 | Arteria lusoria dextra | CoA repair (patch plasty) [25 y] | Lusoria artery transposition [42 y] | 42 y | None | |
16 | None | CoA repair (patch plasty) [30 y] | 47 y | None | ||
17 | None | CoA repair (patch plasty) [45 y] | 71 y | None | ||
18 | BAV, aortic arch hypoplasia | CoA repair (patch plasty) [16 y] | David Procedure, ascending aorta replacement [40 y] | 40 y | None | |
19 | None | CoA repair (patch plasty) [20 y] | 75 y | LICA replacement (vein graft) [69 y] | ||
20 | None | CoA repair (patch plasty) [16 y] | 44 y | None | ||
21 | None | CoA repair (interposition graft) [23 y] | 55 y | Carotido-subclavian bypass, TEVAR | ||
22 | BAV, PDA | CoA repair (patch plasty) [20 y] | Aortic valve replacement [29 y] | 57 y | None | |
23 | None | CoA repair (interposition graft) [12 y] | 63 y | None | ||
24 | None | CoA repair (patch plasty) [21 y] | 44 y | None | ||
25 | BAV, Arteria lusoria dextra | CoA repair (patch plasty) [34 y] | 47 y | None |
Characteristics | N = 25 |
---|---|
Elective | 22 (88%) |
Urgent | 2 (8%) |
Emergent | 1 (4%) |
Characteristics | N = 25 |
---|---|
Operation time (minutes) | 249.2 ± 54.35 |
Bypass time (minutes) | 88.2 ± 40.5 |
Cross-clamp time (minutes) | 50.5 ± 20.5 |
Ventilation time (hours) | 12.4 (10.2–19.5) |
Clamping proximal to left subclavian artery | 16 (64%) |
Intercostal artery reinsertion | 1 (4%) |
Characteristics | N = 25 |
---|---|
Respiratory failure | 3 (12%) |
Tracheostomy | 2 (5%) |
Left vocal cord paraparesis | 6 (24%) |
Sepsis | 0 (0%) |
Wound infection | 0 (0%) |
Bleeding requiring rethoracotomy | 5 (20%) |
Stroke | 0 (0%) |
Temporary paraplegia/paraparesis | 1 (4%) |
Permanent paraplegia/paraparesis | 0 (0%) |
Acute kidney injury | 1 (4%) |
Dialysis | 0 (0%) |
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Deniz, E.; Bobylev, D.; Krüger, H.; Salman, J.; Zubarevich, A.; Martens, A.; Kaufeld, T.; Schmack, B.; Weymann, A.; Ruhparwar, A.; et al. The Fate of the Aorta after Coarctation Repair: Open Surgical Replacement of Descending Aorta in a High-Volume Unit. J. Clin. Med. 2024, 13, 5345. https://doi.org/10.3390/jcm13185345
Deniz E, Bobylev D, Krüger H, Salman J, Zubarevich A, Martens A, Kaufeld T, Schmack B, Weymann A, Ruhparwar A, et al. The Fate of the Aorta after Coarctation Repair: Open Surgical Replacement of Descending Aorta in a High-Volume Unit. Journal of Clinical Medicine. 2024; 13(18):5345. https://doi.org/10.3390/jcm13185345
Chicago/Turabian StyleDeniz, Ezin, Dmitry Bobylev, Heike Krüger, Jawad Salman, Alina Zubarevich, Andreas Martens, Tim Kaufeld, Bastian Schmack, Alexander Weymann, Arjang Ruhparwar, and et al. 2024. "The Fate of the Aorta after Coarctation Repair: Open Surgical Replacement of Descending Aorta in a High-Volume Unit" Journal of Clinical Medicine 13, no. 18: 5345. https://doi.org/10.3390/jcm13185345