Short-Term Outcomes of Two Surgical Techniques for the Treatment of Coarctation of the Aorta in Infants: Subclavian Flap Repair and Resection with Extended End-to-End Anastomosis Technique

Mustafa Karaçelik¹, Burçin Abud^2*, Uğur Karagöz¹, Pelin Ozturk¹, Gökhan Albayrak³, Onur Doyurgan¹, Koray Aykut³, Mehmet Güzeloğlu³, Eyüp Hazan³, Osman Nejat Sarıosmanoğlu¹

¹Department of Pediatric Cardiac Surgery, Behcet Uz Children’s Hospital, Izmir, Turkey.
²Department of Cardiovascular Surgery, Izmir Tepecik Research and Training Hospital, Izmir, Turkey.
³Department of Cardiovascular Surgery, Izmir University School of Medicine, Izmir, Turkey.

DOI: 10.4236/wjcd.2015.51001                

Abstract

Background: The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. Methods: Outcomes of two different surgical repairs for coarctation of the aorta in 43 infants were evaluated retrospectively. The study was designed as a nonrandomized, cross-sectional study. The subclavian flap repair was applied to 22 patients (51%) and resection with extended end-to-end anastomosis technique to 21 patients (49%). After all operative survivors were followed up with a mean follow-up of 1.8 ± 0.8 years, data analyzed with t-test and the p value < 0.05 were considered statistically significant. Results: The overall mortality rate was 4.6%. Forty mmHg gradients were determined in a patient from Resection Group postoperatively in the fifteenth month. After the balloon angioplasty, the gradient decreased to 25 mmHg. The presence of ventricular septal defect (p = 0.094) was the only significant predictor of adverse short-term outcome among the associated cardiac defects analyzed. The first-year survival rate was 100% in both groups in isolated coarctation (p = 0.965), however; such rate was found as 100% and 93.25% in Waldhausen Group and Resection Group, respectively in complex coarctation (p = 0.294). Conclusions: Both the subclavian flap repair and resection with extended end-to-end anastomosis for coarctation of the aorta in infants provide excellent short-term outcomes with lower recurrence rates requiring surgery or angioplasty.

Keywords

Congenital Heart Disease, Coarctation of Aorta, Infant

Conflicts of Interest

The authors declare no conflicts of interest.

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