Single-stage Repair Of Coarctation Of The Aortaassociated With Intracardiac Defects In Infants

Objective: To summarize the clinical characteristics of coarctation of the aorta(CoA)associated with intracardiac anomalies in infants.Methods: Medical records of 86 infants who were diagnosed with CoA associated with intracardiac anomalies from August 2009 to August2017 were retrospectively reviewed.Preoperative diagnosis,surgical findings and post-operation follow-up were analyzed.Results: A total of 86 infants diagnosed with CoA associated with intracardiac anomalies were included.Anatomical types included 37 cases of pre-ductal CoA,44 cases of peri-ducutal CoA,and 5 cases of post-ductal CoA.All of the included patients underwent single-stage repair of CoA associated with intracardiac anomalies.Mean operative time was279.0±56.4 min,and the mean length of ICU stay was 7.4±4.7 days.The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly(42.3±17.7 vs22.1±9.4mmHg,P<0.001),and 7 early deaths were observed after surgery.The mean follow-up time of 79 hospital survivors was 31.0±27.4 months,and no late death was found.Transcoarctation gradient of hospital survivors in the last time follow-up was 21.2±11.0mmHg.Transcoarctation gradient of 29 cases was higher than 20 mmHg,however,only 4 cases with significant clinical symptom of lower limbs retardation were recommended for balloon angioplasty consultant.The cumulative recoarctation-free survival in 2-year follow-up was 69.2%.Conclusion: To avoid early second-stage operations,single-stage repair of CoA associated with intracardiac anomalies was effective and safe,and the outcomes of early-to mid-term follow-up were satisfactory.