Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;43(1):17-26.
doi: 10.1007/s00246-021-02685-z. Epub 2021 Aug 2.

Effectiveness of Repair of Aortic Coarctation in Neonates: A Long-Term experience

Chiara Minotti  1 , Manuela Scioni  2 , Biagio Castaldi  3 , Alvise Guariento  4   5 , Roberta Biffanti  3 , Giovanni Di Salvo  3 , Vladimiro Vida  4 , Massimo A Padalino  4
Affiliations

Effectiveness of Repair of Aortic Coarctation in Neonates: A Long-Term experience

Chiara Minotti et al. Pediatr Cardiol. 2022 Jan.

Abstract

To evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neonates. This is a retrospective clinical review of neonates with CoAo, who underwent surgery between 1995 and 2019. Data were retrieved from our institutional database, to identify preoperative and postoperative characteristics. Statistical analysis was performed by means of relative risk ratio and Cox and logistic multivariate analysis. 218 consecutive neonates (M/F: 129/89, median age 11 days, IQR 7-17 days) were included; 202 (92.7%) had a left thoracotomy; 178 underwent extended end-to-end anastomosis (EEEA, 81.6%). Hypoplastic aortic arch (HAA) was present in 102 patients (46.8%); complex cardiac anomalies in 85 (39%). Significant postoperative complications occurred in 20 (9.2%). Thirty-day mortality was 2.3% (most in complex types). At a median follow-up of 10.4 years (IQR 5.6-15.0 years; FU completeness 95.9%), there were 8 late deaths (3.7%), all associated to complex CoAo. Among 196 survivors, 177 (93.2%) were in NYHA class I; re-interventions on aortic arch occurred in 9.2% (2.0% were surgical). Freedom from mortality and re-intervention on aorta at 10 years were 94.3% and 96.7%, respectively. Surgical repair of CoAo in newborns without CPB in our series was safe and low-risk, with excellent early and late outcomes.

Keywords: Aortic coarctation; Neonates; Outcome; Surgical repair.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival plot, showing freedom from mortality, overall (a) and according to age subgroup (b)
Fig. 2
Fig. 2
Kaplan–Meier survival plot, showing freedom from re-intervention, overall (a) and according to age subgroup (b)
See this image and copyright information in PMC

References

    1. Baumgartner H, Bonhoeffer P, De Groot NMS, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010) Eur Heart J. 2010;31(23):2915–2957. doi: 10.1093/eurheartj/ehq249. - DOI - PubMed
    1. Singh S, Hakim FA, Sharma A, et al. Hypoplasia, pseudocoarctation and coarctation of the aorta—a systematic review. Heart Lung Circ. 2015;24(2):110–118. doi: 10.1016/j.hlc.2014.08.006. - DOI - PubMed
    1. Brown ML, Burkhart HM, Connolly HM, et al. Coarctation of the aorta: lifelong surveillance is mandatory following surgical repair. J Am Coll Cardiol. 2013;62(11):1020–1025. doi: 10.1016/j.jacc.2013.06.016. - DOI - PubMed
    1. Marelli A, Miller SP, Marino BS, Jefferson AL, Newburger JW. Brain in congenital heart disease across the lifespan: the cumulative burden of injury. Circulation. 2016;133(20):1951–1962. doi: 10.1161/CIRCULATIONAHA.115.019881. - DOI - PMC - PubMed
    1. Luciani GB, Hoxha S, Angeli E, et al. Selective versus standard cerebro-myocardial perfusion in neonates undergoing aortic arch repair: a multi-center study. Artif Organs. 2019;43(8):728–735. doi: 10.1111/aor.13430. - DOI - PubMed