Comparison of surgical and interventional therapy of native and recurrent aortic coarctation regarding different age groups during childhood.

Détails

ID Serval
serval:BIB_727DB7E49C38
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Comparison of surgical and interventional therapy of native and recurrent aortic coarctation regarding different age groups during childhood.
Périodique
European Journal of Cardio-thoracic Surgery
Auteur(s)
Früh S., Knirsch W., Dodge-Khatami A., Dave H., Prêtre R., Kretschmar O.
ISSN
1873-734X (Electronic)
ISSN-L
1010-7940
Statut éditorial
Publié
Date de publication
2011
Peer-reviewed
Oui
Volume
39
Numéro
6
Pages
898-904
Langue
anglais
Résumé
OBJECTIVE: The aim of the study was to analyze immediate results, rate of complications and re-interventions during medium-term outcome in pediatric patients with native or recurrent aortic coarctation. We focused on an age-related therapeutic approach comparing surgical and trans-catheter treatment.
METHODS: This is a retrospective, single-centre, clinical observational trial including 91 consecutive patients (age: 1 day-18 years) treated for native coarctation in 67 and recurrent aortic coarctation in 24 patients. Surgical treatment was performed in 56, trans-catheter treatment with balloon dilatation in 17, and by stent implantation in 18 patients. According to the age groups, we treated 48 children in group A (<6 months of age), 16 in group B (6 months-6 years), and 27 in group C (>6 years). A total of 41 patients in group A were operated (85%), patients in group B received either surgical or trans-catheter treatment (50% vs 50%), and 16 patients in group C were treated by stent implantation (62%).
RESULTS: Immediate results were excellent with a significant release of pressure gradient in all three age groups (64.7% in group A, 69.1% in group B, and 63.3% in group C). Complication rate and re-intervention rate (surgical and interventional) both were [corrected] comparable between the three age groups (complications: group A 8.3%, group B 6.3%, and group C 3.7%, [corrected] re-interventions: group A 16.6%, group B 18.8%, and group C 14.8%). [corrected] Midterm outcome after a median follow-up period of 17.5 months was satisfactory with a re-intervention-free survival after 17.5 months of 83.4%, 81.2%, and 81.5% in group A, group B, and group C, respectively.
CONCLUSIONS: The current strategy of an age-related therapy for native and recurrent aortic coarctation in our institution is surgery in infants <6 months (group A), either surgery or balloon dilatation in younger patients <6 years (group B), while in older children >6 years of age (group C) the trans-catheter treatment with stent implantation is an excellent alternative to surgery. Balloon dilatations showed limited results with an overall re-intervention rate of 53% and, therefore, should mainly be performed as a rescue procedure or in recurrent aortic coarctation in neonates.
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/12/2014 17:45
Dernière modification de la notice
20/08/2019 14:30
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