Outcomes In Patients With Different Operation Method Of Coarctation Of The Aorta

Objective:In this project，the follow-up results was compaired in various surgicaltechniques about the coarctation of the aorta，to provide the reference basis for thefuture optimal operation scheme.Methods:We collected clinical data and follow-up results of patients with narrowoperation treatment in our hospital from January，2000to May，2012.A total of75patients completed the treatment operation,7cases died during hospitalization,17cases lost follow-up,51cases were followed up (75%follow-up rate).The follow-uptime was1months to5years,and echocardiography review,retrospective analysis ofpostoperative early to mid-term follow-up results and influencing factors.Results：51cases were successful follow-up,echocardiography statisticsfollow-up,various operation modes of postoperative pressure,postoperative earlymetaphase pressure difference and pressure difference compared with beforeoperation,there were significant differences(P<0.01).The descending aortaanastomosis group after early, middle pressure differential mean value,were less thanthe other operation mode group,but there was no significant difference between thegroups(P>0.05).Operation effect is not completely,postoperative pressure difference is greaterthan30mmHg,postoperative early metaphase prone to restenosis, but to thedescending aorta anastomosis group was the lowest,25%,while the arch anddescending aorta end-to-side anastomosis group,the incidence rate was66.7%,artificial blood vessel bypass group and patch enlargement group incidencewere all100%.Early postoperative pressure groups over30mmHg,the descendingaorta anastomosis group had the least proportion,12.5%.These patients after middlepressure continues to increase,the group also in the descending aorta anastomosisgroup had the smallest percentage,at31.3%,while the other groups were higher thanthose ratios.In the51follow-up patients，early and late postoperative press gradient of anastomotic site were（22.0±11.0）mmHg、（23.5±13.8）mmHg. Correlation analysisshowed that early anastomotic pressure was the risk factor for the medium-termanastomotic pressure.Single factor analysis revealed that operative age≤3months，operative weight≤5kg and early anastomotic pressure increased were risk factors forthe medium-term postoperative anastomotic pressure.Conclusion:1.Various aortic constriction operation in narrow all can significantlyreduce the preoperative narrow pressure difference,early postoperative and mid-termwhich can still keep the pressure is significantly lower than that before operation,sothe efficacy of various operation method is obvious.2.The Patients who underwent aortic anastomosis surgery had the best follow-upresults,but with no statistical results support,needs to be more data to prove.3.Coarctation of the aorta in patients with postoperative follow-up anastomoticpressure changes with age≤3months,weight≤5Kg and early anastomotic pressuredifference,and there was no correlation with cardiac malformations and genderdifferences.