Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Treatment of Coarctation of the Aorta with Subclavian Flap Aortoplasty in Infants

유아에서 쇄골하동맥피판 대동맥성형술에 의한 대동맥축착의 치료

  • 공준혁 (경북대학교 의과대학 흉부외과학교실) ;
  • 이응배 (경북대학교 의과대학 흉부외과학교실) ;
  • 조준용 (경북대학교 의과대학 흉부외과학교실) ;
  • 전상훈 (경북대학교 의과대학 흉부외과학교실) ;
  • 장봉현 (경북대학교 의과대학 흉부외과학교실) ;
  • 이종태 (경북대학교 의과대학 흉부외과학교실) ;
  • 김규태 (경북대학교 의과대학 흉부외과학교실)
  • Published : 2000.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty(SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. Material and method: Between 1986 and 1998, a total of 25 patients less than 1 year of age(12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0$\pm$3.0 months(mean $\pm$ standard deviation); mean weight was 5.0$\pm$1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. Result: The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one(84%) of 24 hospital survivors were followed for 26.0$\pm$24.0 months. The risk of recoarctation in neonates(33.3%) was a little greater than infants(25.0%) without statistical significance. Conclusion: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment(combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.

Keywords

References

  1. J Thorac Cardiovasc Surg v.14 Congenital coarctation of the aorta and its surgical treatment Grafoord C;Nylin G
  2. J Thorac Cardiovasc Surg v.51 Repair of coarctation of the aorta with a subclavian flap Waldhausen JA;Nahrwold DL
  3. Pediatric cardiac surgery(2nd ed) Coaretation of the aorta Locher JP;Kron IL;Mavroudis C(ed);Backer CL(ed)
  4. Ann Thorac Surg v.58 Operative risk factors and durability of repair of coarctation of the aorta in the neonate Merrill WH;Hoff SJ;Stewart JR;Elkins CC;Granharn TP, Jr;Bender HW, Jr
  5. Ann Thorac Surg v.49 Incidence and risk of reintervention after coarctation repair Kron IL;Flanagen TL;Rheuban KS;Carpentier MA;Gutgesell HP Jr;Blackbourne LH;Nolan SP
  6. J Thorac Cardiovasc Surg v.103 Risk of recoarctation in neonates and infants after repair with patch aortoplasty, subclavian flap, and the combined resection-flap procedure Dietl CA;Torres AR;Favaloro RG;Fessler CL;Grunkemeier GL
  7. Ann Thorac Surg v.48 Appraisal of resection and end-to-end anastomosis for repair of coarctation of the aorta in infancy: preference for resection Van Son JAM;Daniels O;Vincent JG, van Lier HJJ;Lacquet LK
  8. J Thorac CArdiovasc Surg v.104 Can we predict the long-term function of the subclavian flap angtoplasty? Mellgren G;Friberg LG;Bjorkerud S
  9. J Thorac Cardiovasc Surg v.100 A comparison of coarctation resection and subclavian flap angioplasty using ultrasonographically monttored postocclusive reactive hyperemia Van Son JAM;van Asten WNJC;van Lier HJJ;Daniel O;Skotnicik SH;Lacquet LK
  10. Ann Thorac Surg v.52 Coarctation: Do we need to resect ductal tissue? Jonas RA
  11. Ann Thorac Surg v.36 Reversed subclavian flap for arch coarctation of the aorta Hatt JC;Waldhausen JA
  12. J Thorac Cardiovasc Surg v.90 Coarctation of the aorta. a new surgical technique De Mendonca JT;Carvalho MR;Coats RK;Franco FE
  13. J Thorac CArdiovasc Surg v.92 A new technique for repair of aortic coarctation. Subclavian flap aortoplasty with preservation of arterial blood flow to the left arm Meier MA;Lucchese FA;Jazoik W;Nestalla IA;de Mendonca JT
  14. Ann Thorac Surg v.43 Coarctation of the aorta: anastomotic enlargement with subclavian artery:two new surgical options Dictl CA;Torres AR
  15. Ann Thorac Surg v.65 Coarctation repair: modifications of end-to-end anastomosts with subclavian flap angioplasty Hovaguimian H;Senthilnathan V;Iguidbashian JP;McIrvin DM;Start A
  16. Circulation v.74 Extended aortic arch anastomoses for repair of coarctation in infancy Lansman S;Shapiro AJ;Schiller MS(at. al.)
  17. Ann Thorac Surg v.52 Role of extended aortoplasty related to the definition of the aorta Amato JJ;Galdieri RJ;Cotroneo JV
  18. J Thorac Cardiovasc Surg v.101 Long-term floow-up comparting subclavian flap angioplasty to resection with modifed oblique end-to-end anastomosis Sciolaro C;Copeland J;Cork R;Barkenbush M;Donnerstein R;Goldberg S
  19. Ann Thorac Surg v.52 Surgical correction of coarctation in early infancy:Does surgical technique infuence the result? Mcssmer BJ;Minale C;Muhler E;Bernuth GV
  20. J Thorac Cardiovasc Surg v.64 Spinal cord complications floowing surgery for coarctationof the aorta Brewer LA;Fosberg RG;Mulder GA(et. al.)