Objective To analyze the clinical outcome of one-stage repair of aortic coarctation combined with cardiac anomalies and pneumonia. Methods We retrospectively reviewed the clinical data of 26 patients with severe pneumonia undergoing repair of aortic coartation between January 2014 and August 2015, among whom 7 patients (26.9%) received tracheal intubation, 5 patients double incision, and 21 patients single incision. Long-term follow-up results were obtained from outpatient department. Results Two patients died from operations. The mean hospital stay was 18.5±4.5 d, bypass time 93.5±36.4 min, and mechanical ventilation time 89.5±41.3 min. Postoperative complication mainly was pneumonia. During 6-month follow-up at outpatient department, incidence of pneumonia decreased, and children’s growth and development remarkably improved. Conclusion In the case of uncontrollable pneumonia, one-stage repair of aortic coarctation associated with cardiac anomalies still can receive a good outcome.
ObjectiveTo summarize the results of surgical treatment for 79 patients with coarctation of the aorta (CoA) combined with complex anomalies (CA) in recent years.MethodsThe data from 79 patients with CoA combined with CA admitted to Guangzhou Women and Children's Medical Center between January 19, 2010 and September 7, 2017 were collected and analyzed. There were 52 males and 27 females. The median age was 71 days, and the median weight was 4.3 kg. There were 26 patients combined with tracheostenosis and 7 patients with preoperative tracheal intubation. Extended end-to-side anastomosis was used to correct the CoA, and the associated cardiac abnormalities were treated simultaneously by an incision through median sternotomy. All operations were performed by the same group of surgeons.ResultsThe median deep hypothermic circulatory arrest was 18 (13-28) minutes, the median aorta cross-clamp time was 62 (15-199) minutes, the median cardiopulmonary bypass time was 145 (71-674) minutes, the median ventilation time was 72 (9-960) hours, the median length of ICU stay was 144 (12-1 944) hours, and the median length of hospital stay was 24 (2-93) days. Early death occurred in 9 patients and late death occurred in 5 patients. Reoperation occurred in 28 patients and recoarctation developed in 10 patients. After operation, transcoarctation gradient was reduced, and the transcutaneous oxygen saturation, C-reactive protein (CRP), lactate and creatinine were increased. Compared to the survival group, both preoperative and postoperative transcutaneous oxygen saturation were worse and the postoperative levels of plasma brain natriuretic peptide (BNP) and CRP were higher in the death group.ConclusionCorrecting the CoA and the associated CA simultaneously with extended end-to-side anastomosis by an incision through median sternotomy is effective and safe, and the outcomes of immediate and medial-term are satisfactory. Improving oxygenation and limiting elevation of BNP and CRP levels may reduce the death rate.