ZHOU Shuheng 1,2,3 , HUI Chengyi 1,2 , ZHOU Ziqin 1,2,3 , TIAN Miao 1,2,3 , ZHANG Ruyue 1,2,3 , WANG Xin 3,4 , CHEN Shuo 2,3 , YUAN Haiyun 1,2,3 , ZHANG Yong 1,2 , LI Xiaohua 1,2 , CUI Hujun 1,2 , WEN Shusheng 1,2,3 , CHEN Jimei 1,2,3
  • 1. Guangdong Cardiovascular Institute, Guangzhou, 510100, P. R. China;
  • 2. Department of Cardiac Surgery, Guangdong Provincial People’s Hospital, Southern Medical University, Guangzhou, 510100, P. R. China;
  • 3. Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510100, P. R. China;
  • 4. School of Medicine, South China University of Technology, Guangzhou, 510006, P. R. China;
CHEN Jimei, Email: chenjimei@gdph.org.cn
Ventricular septal defect; coarctation of the aorta; mild; progression; risk factors
10.7507/1007-4848.202412059
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Objective  To analyze the aortic development in patients with mild coarctation of the aorta (CoA) and ventricular septal defect (VSD) after isolated VSD repair and to explore the risk factors affecting postoperative aortic development. ​Methods  A retrospective analysis was conducted on the clinical data of 4231 patients who underwent VSD repair at Guangdong Provincial People’s Hospital from January 2018 to August 2023. Patients with mild CoA were selected as the study subjects. Based on whether CoA progressed postoperatively, patients were divided into a progression group and a non-progression group. Univariate and multivariate analyses were performed, and a logistic regression model was established to analyze the factors affecting postoperative aortic development. ​Results  A total of 231 patients were included, with 142 males and 89 females, and a median age of 223 (105, 635) days. Among the 231 patients, 30 showed varying degrees of mild CoA progression during postoperative follow-up, with an incidence rate of 13%. Multivariate logistic regression analysis revealed that higher preoperative pulmonary artery pressure [OR=2.053, 95%CI (1.095, 3.85), P=0.025] and larger VSD [OR=20.2, 95%CI (1.614, 254.44), P=0.025] were risk factors for postoperative CoA progression (P<0.05). ​Conclusion  Most patients with mild CoA and VSD exhibited varying degrees of catch-up growth in the aorta postoperatively. Preoperative pulmonary artery pressure and VSD size were influencing factors for postoperative CoA progression, necessitating more cautious surgical strategies and closer follow-up for this subset of patients.

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