Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants
Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac su...
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Gespeichert in:
| Autor*in: |
Y. Truba [verfasserIn] I. Dziuryi [verfasserIn] R. Sekelyk [verfasserIn] O. Golovenko [verfasserIn] V. Lazoryshynets [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch ; Russisch ; Ukrainisch |
| Erschienen: |
2021 |
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| Übergeordnetes Werk: |
In: Український журнал серцево-судинної хірургії - Professional Edition Eastern Europe, 2020, (2021), 2 (43), Seite 56-61 |
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| Übergeordnetes Werk: |
year:2021 ; number:2 (43) ; pages:56-61 |
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Link aufrufen |
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| DOI / URN: |
10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 |
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DOAJ047778091 |
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| 520 | |a Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. | ||
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10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 doi (DE-627)DOAJ047778091 (DE-599)DOAJa010b46b1a2f4713bf3aae41be9c9c75 DE-627 ger DE-627 rakwb eng rus ukr RD1-811 Y. Truba verfasserin aut Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. echocardiography aortic arch segments pressure gradient left ventricular ejection fraction treatment tactics Surgery I. Dziuryi verfasserin aut R. Sekelyk verfasserin aut O. Golovenko verfasserin aut V. Lazoryshynets verfasserin aut In Український журнал серцево-судинної хірургії Professional Edition Eastern Europe, 2020 (2021), 2 (43), Seite 56-61 (DE-627)1760646040 26645971 nnns year:2021 number:2 (43) pages:56-61 https://doi.org/10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 kostenfrei https://doaj.org/article/a010b46b1a2f4713bf3aae41be9c9c75 kostenfrei http://cvs.org.ua/index.php/ujcvs/article/view/419 kostenfrei https://doaj.org/toc/2664-5963 Journal toc kostenfrei https://doaj.org/toc/2664-5971 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2021 2 (43) 56-61 |
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10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 doi (DE-627)DOAJ047778091 (DE-599)DOAJa010b46b1a2f4713bf3aae41be9c9c75 DE-627 ger DE-627 rakwb eng rus ukr RD1-811 Y. Truba verfasserin aut Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. echocardiography aortic arch segments pressure gradient left ventricular ejection fraction treatment tactics Surgery I. Dziuryi verfasserin aut R. Sekelyk verfasserin aut O. Golovenko verfasserin aut V. Lazoryshynets verfasserin aut In Український журнал серцево-судинної хірургії Professional Edition Eastern Europe, 2020 (2021), 2 (43), Seite 56-61 (DE-627)1760646040 26645971 nnns year:2021 number:2 (43) pages:56-61 https://doi.org/10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 kostenfrei https://doaj.org/article/a010b46b1a2f4713bf3aae41be9c9c75 kostenfrei http://cvs.org.ua/index.php/ujcvs/article/view/419 kostenfrei https://doaj.org/toc/2664-5963 Journal toc kostenfrei https://doaj.org/toc/2664-5971 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2021 2 (43) 56-61 |
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10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 doi (DE-627)DOAJ047778091 (DE-599)DOAJa010b46b1a2f4713bf3aae41be9c9c75 DE-627 ger DE-627 rakwb eng rus ukr RD1-811 Y. Truba verfasserin aut Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. echocardiography aortic arch segments pressure gradient left ventricular ejection fraction treatment tactics Surgery I. Dziuryi verfasserin aut R. Sekelyk verfasserin aut O. Golovenko verfasserin aut V. Lazoryshynets verfasserin aut In Український журнал серцево-судинної хірургії Professional Edition Eastern Europe, 2020 (2021), 2 (43), Seite 56-61 (DE-627)1760646040 26645971 nnns year:2021 number:2 (43) pages:56-61 https://doi.org/10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 kostenfrei https://doaj.org/article/a010b46b1a2f4713bf3aae41be9c9c75 kostenfrei http://cvs.org.ua/index.php/ujcvs/article/view/419 kostenfrei https://doaj.org/toc/2664-5963 Journal toc kostenfrei https://doaj.org/toc/2664-5971 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2021 2 (43) 56-61 |
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10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 doi (DE-627)DOAJ047778091 (DE-599)DOAJa010b46b1a2f4713bf3aae41be9c9c75 DE-627 ger DE-627 rakwb eng rus ukr RD1-811 Y. Truba verfasserin aut Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. echocardiography aortic arch segments pressure gradient left ventricular ejection fraction treatment tactics Surgery I. Dziuryi verfasserin aut R. Sekelyk verfasserin aut O. Golovenko verfasserin aut V. Lazoryshynets verfasserin aut In Український журнал серцево-судинної хірургії Professional Edition Eastern Europe, 2020 (2021), 2 (43), Seite 56-61 (DE-627)1760646040 26645971 nnns year:2021 number:2 (43) pages:56-61 https://doi.org/10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 kostenfrei https://doaj.org/article/a010b46b1a2f4713bf3aae41be9c9c75 kostenfrei http://cvs.org.ua/index.php/ujcvs/article/view/419 kostenfrei https://doaj.org/toc/2664-5963 Journal toc kostenfrei https://doaj.org/toc/2664-5971 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2021 2 (43) 56-61 |
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10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 doi (DE-627)DOAJ047778091 (DE-599)DOAJa010b46b1a2f4713bf3aae41be9c9c75 DE-627 ger DE-627 rakwb eng rus ukr RD1-811 Y. Truba verfasserin aut Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. echocardiography aortic arch segments pressure gradient left ventricular ejection fraction treatment tactics Surgery I. Dziuryi verfasserin aut R. Sekelyk verfasserin aut O. Golovenko verfasserin aut V. Lazoryshynets verfasserin aut In Український журнал серцево-судинної хірургії Professional Edition Eastern Europe, 2020 (2021), 2 (43), Seite 56-61 (DE-627)1760646040 26645971 nnns year:2021 number:2 (43) pages:56-61 https://doi.org/10.30702/ujcvs/21.4306/t023056-061/007.21-053.2 kostenfrei https://doaj.org/article/a010b46b1a2f4713bf3aae41be9c9c75 kostenfrei http://cvs.org.ua/index.php/ujcvs/article/view/419 kostenfrei https://doaj.org/toc/2664-5963 Journal toc kostenfrei https://doaj.org/toc/2664-5971 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2021 2 (43) 56-61 |
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Truba</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2021</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. 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Two-Stage Repair of Aortic Arch Hypoplasia Associated with Other Congenital Heart Defects in Newborns and Infants |
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Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. |
| abstractGer |
Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. |
| abstract_unstemmed |
Background. The optimal tactics of surgical treatment of aortic arch hypoplasia combined with other congenital heart defects remain controversial. In recent years, the leading clinics of the world prefer one-stage repair of such a combination, however, two-stage treatment is still used by cardiac surgeons and remains one of the variants of surgical tactics. The aim. To analyze immediate and long-term results of a two-stage repair of aortic arch hypoplasia with other con-genital heart defects in newborns and infants. Materials and methods. The study included 138 infants who were selected for a two-stage repair of aortic arch hy-poplasia with other congenital heart defects. There were 79 (57.2%) male and 59 (42.8%) female patients. The mean age of the patients was 1.4 ± 0.7 months, mean body weight was 4.1 ± 2.0 kg. The main method of the defect diagnosis and evaluation of immediate and long-term results was echocardiographic examination. The aortic arch segment was consid-ered hypoplastic if the Z-score deviation was less than –2.0. Results. The hospital mortality rate was 5.8% (n = 8). Two patients (1.4%) had delayed sternal closure in the early postoperative period. As a result of severe myocardial failure, two patients underwent extracorporeal membrane oxy-genation (ECMO). According to echocardiography before discharge, the mean pressure gradient at the site of aortic arch repair was 16 ± 6 mmHg. There was one death in the follow-up period. In 16 (11.5%) patients, aortic arch restenosis developed in the postoperative period. In total, 20 re-interventions were performed: 11 endovascular balloon dilatations and 9 surgical re-interventions. In the early postoperative period, aortopexia was performed in two patients (1.4%) due to compression of the left main bronchus. Conclusions. Two-stage repair of aortic arch hypoplasia with other congenital heart defects in newborns and infants is effective and safe treatment with good immediate and long-term results. This study shows that this surgical strategy can be effectively used in this complex pathology. |
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