Abstract
Introduction. Question of timing and tactics of surgical treatment coarctation of the aorta (CoAo) in children first year of life is still extremely actual.
Objective. To evaluate the effectiveness of surgical and endovascular methods of treatment in children with isolated CoAo.
Material and methods. We produced a retrospective analysis of 795 cases with isolated CoAo undergoing treatment of A.N. Bakoulev Center from 2005 to 2015. The children were divided into two groups depending on the type of treatment: group 1: resection of CoAo (n=734; 92.3%), group 2 – balloon angioplasty (BA), n=61; 7.7%.
Results. Groups did not differ significantly on age (р =0.11) and weight (р=0.43). Patients in group 1 had significantly large size of the aortic (р=0.007) and mitral (р=0.023) valves; size of the left ventricle (р=0.001). The size of the aortic isthmus was significantly (р=0.016) higher in patients of group 2. Hospital mortality in group 1 was 2.9% (n=21), 2 – 3.3% (n=2). In catamnesis group 2 recoarctation (reCoAo) developed in 28/59 (47.5%), in group 1 – 40/713 (5.6%), p<0.0001. Reoperation was needed in group 2 significantly earlier (p<0.0001). Risk factor for the development of reCoAo (p<0.0001) in the groups were age up to 28 days of life. In the 2nd group had a significant (p<0.02) influence on the development of reCoAo low Z-score of the isthmus of aorta.
Conclusion. BA is similar to resection short-term outcomes and poor long-term, which combined with a less traumatic character of the method allows to recommend it as a first stage of assistance to patients in critical condition.
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About the authors
- Svobodov Andrey Andreevich, Dr Med. Sc., Chief Researcher, Cardiac Surgeon, orcid.org/0000-0003-2523-5212;
- Levchenko Elena Grigor'evna, Cand. Med. Sc., Senior Researcher, Cardiologist, orcid.org/0000-0001-8242-6221;
- Anderson Aleksey Georgievich, Cand. Med. Sc., Leading Researcher, Cardiologist, orcid.org/0000-0002-0480-698X;
- Tumanyan Margarita Rollandovna, Dr Med. Sc., Professor, Head of Department, orcid.org/0000-0003-4250-8198;
- Pursanov Manolis Georgievich, Dr Med. Sc., Leading Researcher, Head of Department, orcid.org/0000-0002-1421-1795
