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Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation
BACKGROUND: Although various surgical techniques have been reported for aortic arch reconstruction for proximal and distal transverse arch (PDTA) hypoplasia, no consensus has been reached on a surgical option for initial arch reconstruction. This study was undertaken to review various arch reconstru...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976682/ https://www.ncbi.nlm.nih.gov/pubmed/35378967 http://dx.doi.org/10.21037/tp-21-557 |
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author | Li, Cong Ma, Jidan Yan, Yichen Chen, Hongtong Shi, Guocheng Chen, Huiwen Zhu, Zhongqun |
author_facet | Li, Cong Ma, Jidan Yan, Yichen Chen, Hongtong Shi, Guocheng Chen, Huiwen Zhu, Zhongqun |
author_sort | Li, Cong |
collection | PubMed |
description | BACKGROUND: Although various surgical techniques have been reported for aortic arch reconstruction for proximal and distal transverse arch (PDTA) hypoplasia, no consensus has been reached on a surgical option for initial arch reconstruction. This study was undertaken to review various arch reconstruction options for PDTA hypoplasia in Chinese infants. METHODS: A retrospective review of 121 infants who underwent initial arch reconstruction of the proximal and distal aortic arches between 2010 and 2020 was performed. Freedom from recoarctation was analyzed using Kaplan-Meier analysis. Univariate and multivariable Cox regression analyses were performed to determine perioperative data associated with an increased risk of recoarctation after surgery. RESULTS: Aortic arch reconstruction was performed by end-to-side anastomosis (ESA) (n=37) or patch repair [autologous pericardial patch (APP), n=53; bovine pericardial patch (BPP), n=20; autologous pulmonary artery patch (APAP), n=11]. The relative diameter of the proximal arch was 0.51±0.07, and the relative diameter of the distal arch was 0.43±0.07. The median follow-up time was 679 (range, 388–1,362) days. Recoarctation was observed in 44 (36.4%) patients. ESA was an independent risk factor for further development of recoarctation after the initial aortic arch reconstruction [hazard ratio (HR) =2.13; P=0.020]. CONCLUSIONS: Aortic arch reconstruction via ESA was an independent risk factor for late recoarctation of the proximal and distal aortic arches in patients who underwent the initial surgery in infancy. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCTR2100048212. |
format | Online Article Text |
id | pubmed-8976682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-89766822022-04-03 Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation Li, Cong Ma, Jidan Yan, Yichen Chen, Hongtong Shi, Guocheng Chen, Huiwen Zhu, Zhongqun Transl Pediatr Original Article BACKGROUND: Although various surgical techniques have been reported for aortic arch reconstruction for proximal and distal transverse arch (PDTA) hypoplasia, no consensus has been reached on a surgical option for initial arch reconstruction. This study was undertaken to review various arch reconstruction options for PDTA hypoplasia in Chinese infants. METHODS: A retrospective review of 121 infants who underwent initial arch reconstruction of the proximal and distal aortic arches between 2010 and 2020 was performed. Freedom from recoarctation was analyzed using Kaplan-Meier analysis. Univariate and multivariable Cox regression analyses were performed to determine perioperative data associated with an increased risk of recoarctation after surgery. RESULTS: Aortic arch reconstruction was performed by end-to-side anastomosis (ESA) (n=37) or patch repair [autologous pericardial patch (APP), n=53; bovine pericardial patch (BPP), n=20; autologous pulmonary artery patch (APAP), n=11]. The relative diameter of the proximal arch was 0.51±0.07, and the relative diameter of the distal arch was 0.43±0.07. The median follow-up time was 679 (range, 388–1,362) days. Recoarctation was observed in 44 (36.4%) patients. ESA was an independent risk factor for further development of recoarctation after the initial aortic arch reconstruction [hazard ratio (HR) =2.13; P=0.020]. CONCLUSIONS: Aortic arch reconstruction via ESA was an independent risk factor for late recoarctation of the proximal and distal aortic arches in patients who underwent the initial surgery in infancy. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCTR2100048212. AME Publishing Company 2022-03 /pmc/articles/PMC8976682/ /pubmed/35378967 http://dx.doi.org/10.21037/tp-21-557 Text en 2022 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Li, Cong Ma, Jidan Yan, Yichen Chen, Hongtong Shi, Guocheng Chen, Huiwen Zhu, Zhongqun Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title | Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title_full | Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title_fullStr | Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title_full_unstemmed | Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title_short | Surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
title_sort | surgical options for proximal and distal transverse arch hypoplasia in infants with coarctation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976682/ https://www.ncbi.nlm.nih.gov/pubmed/35378967 http://dx.doi.org/10.21037/tp-21-557 |
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