Peng Le,Zhou Xiaodong,Zheng Fengnan,et al.One-stage repair of aortic coarctation plus intra-cardiac anomalies in neonates[J].Journal of Clinical Pediatric Surgery,,18():884-887.[doi:10.3969/j.issn.1671-6353.2019.10.017]
One-stage repair of aortic coarctation plus intra-cardiac anomalies in neonates
- Keywords:
- Aortic Coarctation/SU; Heart Defects; Congenital/SU; Treatment Outcome; Infant; Newborn
- CLC:
- R543.1;R542.5;R654.2
- Abstract:
- Objective To summarize the clinical experience of one-stage of aortic coarctation plus intra-cardiac anomalies in neonates.Methods From March 2015 to March 2017,a total of 19 children of aortic coarctation plus intra-cardiac anomalies were assigned into one-stage (n=12) and two-stage (n=7) groups.In one-stage group,repair was performed by median sternotomy.Two groups were compared with regards to cardiopulmonary bypass time,aortic clamping time,ventilator assisted time and duration of intensive care unit (ICU).Results Cardiopulmonary bypass time was longer in one-stage group than that in two-stage group[(93.3±16.3) vs.(56.6±9.8) min].The difference was statistically significant (t=5.081,P<0.01);aortic clamping time[(47.3±15.1)vs.(29.3±8.1) min].The difference was statistically significant(t=2.768,P=0.01).During a routine postoperative follow-up period of 1-12 months,residual pressure gradient of aortic arch was obviously higher in one-stage group than that in two-stage group[(9.84±17.2) vs.(27.3±37.1) mmHg].The difference was statistically significant(t=3.499,P<0.01);However,no statistically significant inter-group differences existed in postoperative value of upper/lower extremity systolic pressure gradient or Z value of aortic arch (P>0.05).During a postoperative follow-up period of one year,residual stenosis was lower in one-stage group than that in two-stage group[(9.83±9.69) vs.(34.8±17.03)] and the difference was statistically significant (t=2.516,P=0.04).Neither group had any mortal case.Cardiopulmonary bypass time in one-stage group was higher than two-stage group (102±102 vs.56.6±9.8 min,P<0.05);aortic clamping time had no inter-group difference (49.6±34.9 vs.29.3±8.1 min,P>0.05).During a postoperative follow-up period of 1 to 12 months,residual pressure gradient of aortic arch was lower in one-stage group than that in two-stage group[(9.8±17) vs.(27±37) mmHg,P<0.05] and the difference was statistically significant.No significant inter-group difference existed in pressure gradient of upper/lower extremity or Z value of aortic arch.Conclusion The immediate outcome of one-stage repair of aortic coarctation plus intra-cardiac anomalies is excellent in neonates.
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Memo
收稿日期:2018-03-05。
基金项目:深圳市"三名工程"项目（编号：SZSM201612003）
作者简介:彭乐,Email:958165737@qq.com