当前位置: 首页 > 详情页

Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age

文献详情

资源类型:

收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Heart Ctr, Beijing 100029, Peoples R China
出处:
ISSN:

关键词: interrupted aortic arch ventricular septal defect pulmonary hypertension

摘要:
Background Interrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease.Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.However,in China,patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common.So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.Methods From January 2009 to December 2012,19 patients with IAA have undergone complete single-stage repair.The patients' mean age was 4.4 years,ranging 1 to 15 years; and their mean weight was 12.8 kg,ranging 4.2 to 36.0 kg.Fifteen IAA were type A,four were type B.Preoperative cardiac catheterization data were available from all patients.Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured.The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case.All patients underwent echocardiographic examinations before discharged from the hospital.In addition,cardiac catheterization and echocardiographic examinations were performed during follow-up.Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients.Mean follow-up was (1.6±0.8) years.Results There were two hospital deaths (2/19,11%).One patient died of pulmonary hypertension crisis,and another died of postoperative low cardiac output.Five cases had other main postoperative complications but no postoperative neurologic complications.Seventeen survivors were followed up,and there were no late deaths or reoperation.Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes.Two patients required delayed sternal closure at two days postoperatively.Intensive care unit and hospital stays were (9±8) days and (47±24) days,respectively.Pressure gradients across the anastomosis at most recent follow up were less than 22 mmHg.mPAP regressed significantly from preoperative (62.1±8.1) mmHg to postoperative (37.3±11.3) mmHg (P <0.001) and (24.2±6.0) mmHg at six months after discharged from the hospital (P <0.001).The pulmonary vascular resistance also regressed significantly from preoperative (1 501.4±335.7) dyn·s·cm-5 to (485.0±215.1) dyn·s·cm-5 at six months after discharged from the hospital (P <0.001).The majority of the seventeen patients (89%) were in New York Heart Association (NYHA) class Ⅰ,and 11% remained in NYHA class Ⅱ.Conclusions Single-stage repair of patients with IAA,VSD and PDA over one year of age can have good surgical results and functional outcomes.Assessment and treatment of pulmonary artery pressure pre-operatively and postoperatively was crucial.mPAP and pulmonary vascular resistance may have regress significantly compared to preoperative values.

基金:
语种:
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2013]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 医学:内科
JCR分区:
出版当年[2012]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2012版] 出版当年五年平均 出版前一年[2011版] 出版后一年[2013版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Heart Ctr, Beijing 100029, Peoples R China
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:17010 今日访问量:0 总访问量:909 更新日期:2025-04-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 首都医科大学宣武医院 技术支持:重庆聚合科技有限公司 地址:北京市西城区长椿街45号宣武医院