Long-term outcome of one-stage repair of interrupted aortic arch in neonate with cardiac anomalies_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Kan ,  ZHUANG Jian , CHEN Jimei , CEN Jianzheng , WEN Shusheng , XU Gang , LUO Dandong

Department of Pediatric Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou, 510080, P.R.China;

Corresponding author：

ZHUANG Jian, Email: zhuangjian5413@tom.com

Keywords：

Interrupted aortic arch; neonate; one-stage repair

DOI：

10.7507/1007-4848.201607025

Video：

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Objective To review the clinical experience of one-stage repair of interrupted aortic arch(IAA) in neonate with cardiac anomalies. Methods We retrospectively analyzed the clinical data of 21 patients (18 males, 3 females) with IAA total repair in our hospital between May 2003 and September 2014. The average age of patients was 6–26 (15.9±5.8) days and the mean body weight was 3.3±0.4 kg. Fourteen patients belonged to IAA type A, and 7 patients to type B. All patients were complicated with ventricular septal defect, atrial septal defect, and patent ductus artefious. All patients with cardiac anomalies underwent one-stage repair through median sternotomy. The aortic continuity was reestablished by anastomosis between the descending aortic segment and aortic arch. Results CPB time was 92–174 (132.6±27.1) min, and aortic cross clamping time was 48-118 (70.9±18.8) min. Hospital day was 4-52 (28.0±12.1) d. There were 3 postoperative deaths. Causes of death included a cardiac arrest in one patient, hematosepsis in one patient, and a pulmonary hypertension crisis in one patient. Eighteen patients were followed up for 3 months to 11 years and the results were excellent. Conclusion One-stage repair of IAA in neonate with cardiac anomalies can improve life quality of patients and achieve good results.

Citation： ZHOU Kan, ZHUANG Jian, CHEN Jimei, CEN Jianzheng, WEN Shusheng, XU Gang, LUO Dandong. Long-term outcome of one-stage repair of interrupted aortic arch in neonate with cardiac anomalies. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(5): 346-349. doi: 10.7507/1007-4848.201607025 Copy

1.	Oosterhof T, Azakie A, Freedom RM, et al. Associated factors and trends in outcomes of interrupted aortic arch. Ann Thorac Surg, 2004, 78(5): 1696-1702.
2.	Gaynor JW, Wernousky G, Rychik J. Outcome following single-stage repair of coarctation with ventricular septal defect. Eur J Cardiothorac Surg, 2000, 18(5): 62-67.
3.	Barratt-Boyes BG, Nicholls TT, Brandt PW, et al. Aortic arch interruption associated with patent ductus arteriosus, ventricular septal defect, and total anomalous pulmonary venous connection. Total correction in an 8-day-old infant by means of profound hypothermia and limited cardiopulmonary bypass. J Thorac Cardiovasc Surg, 1972, 63(3): 367-373.
4.	Schreiber C, Eicken A, Vogt M, et al. Repair of interrupted aortic arch: results after more than 20 years. Ann Thorac Surg, 2000, 70(6): 1896-1900.
5.	Ng’Walali PM, Ohtsu Y, Tsunenari S. Interrupted aortic arch with ventricular septal defect: an unsuspected fatal congenital anomaly in forensic pathology. J Clin Forensic Med, 2002, 9(4): 185-188.
6.	Brown JW, Ruzmetov M, Okada Y, et al. Outcomes in patients with interrupted aortic arch and associated anomalies: a 20-year experience. Eur J Cardiothorac Surg, 2006, 29(5): 666-674.
7.	Walters HL 3 rd, Ionan CE, Thomas RL, et al. Single-stage versus 2-stage repair of coarctation of the aorta with ventricular septal defect. J Thorac Cardiovasc Surg, 2008, 135(4): 754-761.
8.	Sudarshan CD, Cochrane AD, Jun ZH, et al. Repair of coarctation of the aorta in infants weighing less than 2 kilograms. Ann Thorac Surg, 2006, 82(1): 158-163.
9.	Tom-Salazar OH, Steinberger J, Thomas W, et al. Long-term follow up of patients after coarctation of the aorta repair. Am J Cardiol, 2002, 89(5): 541-547.
10.	Mccrindle BW, Tchervenkov CI, Konstantinov IE, et al. Risk factors associated with mortality and interventions in 472 neonates with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg, 2005, 129(2): 343-350.
11.	Mckenzie ED, Andropoulos DB, Dibardino D, et al. Congenital heart surgery 2005: the brain: it’s the heart of the matter. Am J Surg, 2005, 190(2): 289-294.
12.	严勤, 丁文祥, 苏肇伉, 等. 一期手术矫治先天性主动脉弓中断. 中国胸心血管外科临床杂志, 2002, 9(4): 246-250.
13.	Samir K, Riberi A, Ghez O, et al. Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable? Eur J Cardiothorac Surg, 2002, 21(5): 787-793.
14.	潘燕军, 张海波, 王顺民, 等. 新生儿心脏手术后延迟关胸的临床分析. 中国胸心血管外科临床杂志, 2015, 22(6): 560-563.
15.	Shin HJ, Jhang WK, Park JJ, et al. Impact of delayed sternal closure on postoperative infection or wound dehiscence in patients with congenital heart disease. Ann Thorac Surg, 2011, 92(2): 705-709.
16.	Sugimoto A, Ota N, Miyakoshi C, et al. Mid- to long-term aortic valve-related outcomes after conventional repair for patients with interrupted aortic arch or coarctation of the aorta, combined with ventricular septal defect: the impact of bicuspid aortic valvedagger. Eur J Cardiothorac Surg, 2014, 46(6): 952-960.
17.	罗丹东, 陈寄梅, 岑坚正, 等. 继发于先天性心脏病术后的主动脉瓣下狭窄手术矫治分析. 中国胸心血管外科临床杂志, 2013, (6): 623-627.
18.	Jegatheeswaran A, McCrindle BW, Blackstone EH, et al. Persistent risk of subsequent procedures and mortality in patients after interrupted aortic arch repair: a Congenital Heart Surgeons’ Society Study. J Thorac Cardiovasc Surg, 2010, 140(5): 1059-1075.
19.	Birim O, van Gameren M, de Jong PL, et al. Outcome after reoperation for atrioventricular septal defect repair. Interact Cardiovasc Thorac Surg, 2009, 9(1): 83-87.
20.	Ilbawi MN, Idriss F S, Deleon SY, et al. Surgical management of patients with interrupted aortic arch and severe subaortic stenosis. Ann Thorac Surg, 1988, 45(2): 174-180.

1. Oosterhof T, Azakie A, Freedom RM, et al. Associated factors and trends in outcomes of interrupted aortic arch. Ann Thorac Surg, 2004, 78(5): 1696-1702.
2. Gaynor JW, Wernousky G, Rychik J. Outcome following single-stage repair of coarctation with ventricular septal defect. Eur J Cardiothorac Surg, 2000, 18(5): 62-67.
3. Barratt-Boyes BG, Nicholls TT, Brandt PW, et al. Aortic arch interruption associated with patent ductus arteriosus, ventricular septal defect, and total anomalous pulmonary venous connection. Total correction in an 8-day-old infant by means of profound hypothermia and limited cardiopulmonary bypass. J Thorac Cardiovasc Surg, 1972, 63(3): 367-373.
4. Schreiber C, Eicken A, Vogt M, et al. Repair of interrupted aortic arch: results after more than 20 years. Ann Thorac Surg, 2000, 70(6): 1896-1900.
5. Ng’Walali PM, Ohtsu Y, Tsunenari S. Interrupted aortic arch with ventricular septal defect: an unsuspected fatal congenital anomaly in forensic pathology. J Clin Forensic Med, 2002, 9(4): 185-188.
6. Brown JW, Ruzmetov M, Okada Y, et al. Outcomes in patients with interrupted aortic arch and associated anomalies: a 20-year experience. Eur J Cardiothorac Surg, 2006, 29(5): 666-674.
7. Walters HL 3 rd, Ionan CE, Thomas RL, et al. Single-stage versus 2-stage repair of coarctation of the aorta with ventricular septal defect. J Thorac Cardiovasc Surg, 2008, 135(4): 754-761.
8. Sudarshan CD, Cochrane AD, Jun ZH, et al. Repair of coarctation of the aorta in infants weighing less than 2 kilograms. Ann Thorac Surg, 2006, 82(1): 158-163.
9. Tom-Salazar OH, Steinberger J, Thomas W, et al. Long-term follow up of patients after coarctation of the aorta repair. Am J Cardiol, 2002, 89(5): 541-547.
10. Mccrindle BW, Tchervenkov CI, Konstantinov IE, et al. Risk factors associated with mortality and interventions in 472 neonates with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg, 2005, 129(2): 343-350.
11. Mckenzie ED, Andropoulos DB, Dibardino D, et al. Congenital heart surgery 2005: the brain: it’s the heart of the matter. Am J Surg, 2005, 190(2): 289-294.
12. 严勤, 丁文祥, 苏肇伉, 等. 一期手术矫治先天性主动脉弓中断. 中国胸心血管外科临床杂志, 2002, 9(4): 246-250.
13. Samir K, Riberi A, Ghez O, et al. Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable? Eur J Cardiothorac Surg, 2002, 21(5): 787-793.
14. 潘燕军, 张海波, 王顺民, 等. 新生儿心脏手术后延迟关胸的临床分析. 中国胸心血管外科临床杂志, 2015, 22(6): 560-563.
15. Shin HJ, Jhang WK, Park JJ, et al. Impact of delayed sternal closure on postoperative infection or wound dehiscence in patients with congenital heart disease. Ann Thorac Surg, 2011, 92(2): 705-709.
16. Sugimoto A, Ota N, Miyakoshi C, et al. Mid- to long-term aortic valve-related outcomes after conventional repair for patients with interrupted aortic arch or coarctation of the aorta, combined with ventricular septal defect: the impact of bicuspid aortic valvedagger. Eur J Cardiothorac Surg, 2014, 46(6): 952-960.
17. 罗丹东, 陈寄梅, 岑坚正, 等. 继发于先天性心脏病术后的主动脉瓣下狭窄手术矫治分析. 中国胸心血管外科临床杂志, 2013, (6): 623-627.
18. Jegatheeswaran A, McCrindle BW, Blackstone EH, et al. Persistent risk of subsequent procedures and mortality in patients after interrupted aortic arch repair: a Congenital Heart Surgeons’ Society Study. J Thorac Cardiovasc Surg, 2010, 140(5): 1059-1075.
19. Birim O, van Gameren M, de Jong PL, et al. Outcome after reoperation for atrioventricular septal defect repair. Interact Cardiovasc Thorac Surg, 2009, 9(1): 83-87.
20. Ilbawi MN, Idriss F S, Deleon SY, et al. Surgical management of patients with interrupted aortic arch and severe subaortic stenosis. Ann Thorac Surg, 1988, 45(2): 174-180.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Long-term outcome of one-stage repair of interrupted aortic arch in neonate with cardiac anomalies

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