Original article: cardiovascularAnatomic reconstruction for recurrent aortic obstruction in infants and children
Section snippets
Material and methods
Since 1995, 21 patients have presented with recurrent aortic arch obstruction after previous repair, 17 boys and 4 girls. After approval from the local institutional review board, a retrospective chart review was conducted such that all preoperative, operative, and hospital course data were reviewed, and the most recent follow-up data were extracted from the cardiology clinic database. Preoperative echocardiograms and catheterization cineangiograms were reviewed by two cardiologists (G.C.K. and
Operative data
There were no intraoperative deaths. The ischemic times for patients undergoing thoracotomy were 15 and 24 minutes. Among patients undergoing median sternotomy, mean cardiopulmonary bypass time was 164.9 ± 70.0 minutes (range, 83 to 387 minutes) and mean aortic cross-clamp time was 90.4 ± 53.6 minutes (range, 53 to 291 minutes). Cumulative DHCA time averaged 27.4 ± 8.7 minutes (range, 14 to 50 minutes) in patients not undergoing RLFP and was 6 and 16 minutes in patients undergoing RLFP as an
Risk factors and pathogenesis for recurrent aortic obstruction
There has been much debate concerning the risk factors for recurrent aortic obstruction after repair of coarctation or interrupted aortic arch. Beekman and associates [12] found that the incidence of recurrence was 1.5% of 197 patients undergoing coarctation repair beyond 3 years of age and 38% of 42 patients undergoing repair in the first 3 months of life. In a recent review of 103 patients undergoing primary coarctation repair, younger age and smaller absolute transverse arch diameter were
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