Chen Renwei,Wang Haifan,Ailixiati·alifu,et al.Analysis of the effect of coarctation of aorta in critically neonatal under off-pump[J].Journal of Clinical Pediatric Surgery,,20():861-865.[doi:10.12260/lcxewkzz.2021.09.012]
Analysis of the effect of coarctation of aorta in critically neonatal under off-pump
- Keywords:
- Aortic Coarctation; Surgical Procedures; Operative; Off-Pump; Treatment Outcome; Infant; Newborn
- CLC:
- R543.1;R726.1
- Abstract:
- Objective To introduce the indications and experiences of surgery for coarctation of the aorta in critically ill neonates with a left posterolateral thoracic incision under off-pump circulation, and to explore its safety and effectiveness.Methods From May 2018 to December 2020, 28 cases of neonates with critically ill aortic coarctation underwent left posterolateral incision and off-pump aortic coarctation surgery.Age 5~26 days(14.3±5.9)d; weight 2.5~4.5 kg(3.7±0.5)kg.Results The whole group of children were performed under non-cardiopulmonary bypass, and there were no cases of transferring to cardiopulmonary bypass or bypass.16 patients underwent aortic constriction resection and enlarged end-to-end anastomosis, and 12 patients with arch dysplasia underwent aortic constriction resection and enlarged end-to-side anastomosis.There were no surgical deaths and no neurological complications in the whole group.The follow-up period was 3~35 months, with an average of 12.3 months.The postoperative Doppler ultrasound measurement of the pressure gradient across the repair point was significantly lower than that before the operation.There were no cases of early intervention and aortic-related airway problems.In 3 months postoperatively, Doppler ultrasound measured the maximum pressure difference of the descending aortic arch in 15 cases (53.6%) <10 mmHg, 11 cases (39.3%) 10~20 mmHg, and 2 cases (7.1%) >20 mmHg.Conclusion Aortic coarctation surgery for critically ill neonates under non-cardiopulmonary bypass left posterolateral incision is a safe method with low mortality and beneficial early outcome, but its long-term outcome needs further follow-up.
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Memo
收稿日期:2021-04-25。
基金项目:海南省卫生健康行业科研项目（编号：20A200158），海南省临床医学中心建设项目
通讯作者:陈仁伟,Email:chenrenwei@sina.com