Surgical management of aortic coarctation in adolescents and adults
Coarctation of the aorta (CoA) in adolescents and adults is often complicated by other cardiac or aortic problems and may carry additional surgical difficulties. Limited studies have reported the surgical outcomes of CoA repair in this particular patient population. We reviewed our contemporary expe...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2017-03, Vol.24 (3), p.430-435 |
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| creator | Yin, Kanhua Zhang, Zhiqi Lin, Yi Guo, Changfa Sun, Yongxin Tian, Ziwei Xie, Qiuchen Wang, Chunsheng |
| description | Coarctation of the aorta (CoA) in adolescents and adults is often complicated by other cardiac or aortic problems and may carry additional surgical difficulties. Limited studies have reported the surgical outcomes of CoA repair in this particular patient population. We reviewed our contemporary experience of open surgical management of CoA in adolescents and adults.
From 2008 to 2016, a total of 60 adolescents and adults (mean age, 32 years) underwent CoA repair at our centre. Of this cohort, 43 patients only underwent CoA repair (isolated group), while the remaining 17 underwent other concomitant cardiac procedures (concomitant group). Ascending-to-descending aortic bypass was the preferred repair technique in the concomitant group. Aortic valve replacement and a Bentall/David procedure were the two most frequently combined procedures.
There were no in-hospital deaths in the isolated group compared with three in the concomitant group (0% vs 17.6%, P = 0.029). The median intensive care unit stay (1 vs 2 days, P |
| doi_str_mv | 10.1093/icvts/ivw353 |
| format | Article |
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From 2008 to 2016, a total of 60 adolescents and adults (mean age, 32 years) underwent CoA repair at our centre. Of this cohort, 43 patients only underwent CoA repair (isolated group), while the remaining 17 underwent other concomitant cardiac procedures (concomitant group). Ascending-to-descending aortic bypass was the preferred repair technique in the concomitant group. Aortic valve replacement and a Bentall/David procedure were the two most frequently combined procedures.
There were no in-hospital deaths in the isolated group compared with three in the concomitant group (0% vs 17.6%, P = 0.029). The median intensive care unit stay (1 vs 2 days, P <0.01) and postoperative hospital stay (6 vs 9 days, P <0.01) were significantly longer in the concomitant group. Postoperative respiratory failure occurred more frequently in the concomitant group (0% vs 17.6%, P = 0.029). The isolated group had better overall survival during follow-up ( P = 0.037). The 5-year overall survival rate was 98% in the isolated group and 82% in the concomitant group.
Surgical management of coarctation in adolescents and adults can achieve similar satisfactory outcomes as their neonatal counterparts, but the complexity of the concomitant procedures is a risk factor for this particular patient population.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivw353</identifier><identifier>PMID: 28011739</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Adult ; Aged ; Aortic Coarctation - mortality ; Aortic Coarctation - surgery ; Child ; China - epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Survival Rate - trends ; Time Factors ; Treatment Outcome ; Vascular Surgical Procedures - methods ; Young Adult</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2017-03, Vol.24 (3), p.430-435</ispartof><rights>The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-9138f2538151bd2b21ca0dea80371ed53bab396ef6bfdf9a1a2d21207ed591073</citedby><cites>FETCH-LOGICAL-c329t-9138f2538151bd2b21ca0dea80371ed53bab396ef6bfdf9a1a2d21207ed591073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28011739$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yin, Kanhua</creatorcontrib><creatorcontrib>Zhang, Zhiqi</creatorcontrib><creatorcontrib>Lin, Yi</creatorcontrib><creatorcontrib>Guo, Changfa</creatorcontrib><creatorcontrib>Sun, Yongxin</creatorcontrib><creatorcontrib>Tian, Ziwei</creatorcontrib><creatorcontrib>Xie, Qiuchen</creatorcontrib><creatorcontrib>Wang, Chunsheng</creatorcontrib><title>Surgical management of aortic coarctation in adolescents and adults</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>Coarctation of the aorta (CoA) in adolescents and adults is often complicated by other cardiac or aortic problems and may carry additional surgical difficulties. Limited studies have reported the surgical outcomes of CoA repair in this particular patient population. We reviewed our contemporary experience of open surgical management of CoA in adolescents and adults.
From 2008 to 2016, a total of 60 adolescents and adults (mean age, 32 years) underwent CoA repair at our centre. Of this cohort, 43 patients only underwent CoA repair (isolated group), while the remaining 17 underwent other concomitant cardiac procedures (concomitant group). Ascending-to-descending aortic bypass was the preferred repair technique in the concomitant group. Aortic valve replacement and a Bentall/David procedure were the two most frequently combined procedures.
There were no in-hospital deaths in the isolated group compared with three in the concomitant group (0% vs 17.6%, P = 0.029). The median intensive care unit stay (1 vs 2 days, P <0.01) and postoperative hospital stay (6 vs 9 days, P <0.01) were significantly longer in the concomitant group. Postoperative respiratory failure occurred more frequently in the concomitant group (0% vs 17.6%, P = 0.029). The isolated group had better overall survival during follow-up ( P = 0.037). The 5-year overall survival rate was 98% in the isolated group and 82% in the concomitant group.
Surgical management of coarctation in adolescents and adults can achieve similar satisfactory outcomes as their neonatal counterparts, but the complexity of the concomitant procedures is a risk factor for this particular patient population.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aortic Coarctation - mortality</subject><subject>Aortic Coarctation - surgery</subject><subject>Child</subject><subject>China - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Surgical Procedures - methods</subject><subject>Young Adult</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAQhi0EoqWwMSOPDIT6bNzYI6r4kioxAHN0sZ3KKImL7RTx7wm0MN2d3kevTg8h58CugWkx92ab09xvP4UUB2QKcqELzZU8_N-1mJCTlN4ZA80EOyYTrhhAKfSULF-GuPYGW9phj2vXuT7T0FAMMXtDTcBoMmYfeup7ija0LpmRSRR7O95Dm9MpOWqwTe5sP2fk7f7udflYrJ4fnpa3q8IIrnOhQaiGS6FAQm15zcEgsw4VEyU4K0WNtdAL1yzqxjYaAbnlwFk5ZhpYKWbkcte7ieFjcClXnR-faVvsXRhSBUryUkngNyN6tUNNDClF11Sb6DuMXxWw6kdb9aut2mkb8Yt981B3zv7Df57ENzWNasI</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Yin, Kanhua</creator><creator>Zhang, Zhiqi</creator><creator>Lin, Yi</creator><creator>Guo, Changfa</creator><creator>Sun, Yongxin</creator><creator>Tian, Ziwei</creator><creator>Xie, Qiuchen</creator><creator>Wang, Chunsheng</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Surgical management of aortic coarctation in adolescents and adults</title><author>Yin, Kanhua ; Zhang, Zhiqi ; Lin, Yi ; Guo, Changfa ; Sun, Yongxin ; Tian, Ziwei ; Xie, Qiuchen ; Wang, Chunsheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-9138f2538151bd2b21ca0dea80371ed53bab396ef6bfdf9a1a2d21207ed591073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aortic Coarctation - mortality</topic><topic>Aortic Coarctation - surgery</topic><topic>Child</topic><topic>China - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Surgical Procedures - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yin, Kanhua</creatorcontrib><creatorcontrib>Zhang, Zhiqi</creatorcontrib><creatorcontrib>Lin, Yi</creatorcontrib><creatorcontrib>Guo, Changfa</creatorcontrib><creatorcontrib>Sun, Yongxin</creatorcontrib><creatorcontrib>Tian, Ziwei</creatorcontrib><creatorcontrib>Xie, Qiuchen</creatorcontrib><creatorcontrib>Wang, Chunsheng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yin, Kanhua</au><au>Zhang, Zhiqi</au><au>Lin, Yi</au><au>Guo, Changfa</au><au>Sun, Yongxin</au><au>Tian, Ziwei</au><au>Xie, Qiuchen</au><au>Wang, Chunsheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical management of aortic coarctation in adolescents and adults</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>24</volume><issue>3</issue><spage>430</spage><epage>435</epage><pages>430-435</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>Coarctation of the aorta (CoA) in adolescents and adults is often complicated by other cardiac or aortic problems and may carry additional surgical difficulties. Limited studies have reported the surgical outcomes of CoA repair in this particular patient population. We reviewed our contemporary experience of open surgical management of CoA in adolescents and adults.
From 2008 to 2016, a total of 60 adolescents and adults (mean age, 32 years) underwent CoA repair at our centre. Of this cohort, 43 patients only underwent CoA repair (isolated group), while the remaining 17 underwent other concomitant cardiac procedures (concomitant group). Ascending-to-descending aortic bypass was the preferred repair technique in the concomitant group. Aortic valve replacement and a Bentall/David procedure were the two most frequently combined procedures.
There were no in-hospital deaths in the isolated group compared with three in the concomitant group (0% vs 17.6%, P = 0.029). The median intensive care unit stay (1 vs 2 days, P <0.01) and postoperative hospital stay (6 vs 9 days, P <0.01) were significantly longer in the concomitant group. Postoperative respiratory failure occurred more frequently in the concomitant group (0% vs 17.6%, P = 0.029). The isolated group had better overall survival during follow-up ( P = 0.037). The 5-year overall survival rate was 98% in the isolated group and 82% in the concomitant group.
Surgical management of coarctation in adolescents and adults can achieve similar satisfactory outcomes as their neonatal counterparts, but the complexity of the concomitant procedures is a risk factor for this particular patient population.</abstract><cop>England</cop><pmid>28011739</pmid><doi>10.1093/icvts/ivw353</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford Journals Open Access Collection; PubMed Central |
| subjects | Adolescent Adult Aged Aortic Coarctation - mortality Aortic Coarctation - surgery Child China - epidemiology Female Follow-Up Studies Humans Male Middle Aged Survival Rate - trends Time Factors Treatment Outcome Vascular Surgical Procedures - methods Young Adult |
| title | Surgical management of aortic coarctation in adolescents and adults |
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