Віддалені результати хірургічного лікування новонароджених із критичною коарктацією аорти

Abstract

За период с 2004 по 2017 гг. в отделении сердечно-сосудистой хирургии Одесской областной детской клинической больницы прооперировано 70 пациентов с критической коарктацией аорты, из них: 21 (31,5 %) новорожденный с изолированной коарктацией аорты, у 16 (22,8 %) больных коарктация аорты сочеталась с дефектом межжелудочковой перегородки, у 31 (45,7 %) пациента — с гипоплазией дистальной дуги аорты и другими интракардиальными аномалиями. Из них 68 (97,2 %) больных хорошо перенесли оперативное вмешательство. Летальность составила 2,8 %.

In the period from 2004 to 2016 in the department of cardiovascular surgery Odessa Regional Pediatric Hospital 70 patients were operated with critical CoA: 21 (31.5%) infants with isolated CoA, 16 (22.8%) patients CoA combined with interventricular septum defect (VSD), 31 patients (45.7%) — CoA combined with distal aortic arch hypoplasia (DАA) and other intracardiac abnormality. Z-score is the significant criterion in detection of hypoplastic aortic arch segments. In patients with DAAH median preoperative diameter of aortic arch segments were “А” — (2.50±0.33) mm (Z-score — 4.04); “В” — (3.73±0.38) mm (Z-score — 3.54); “С” — (7.2±0.6) mm (Z-score 0.03). All operations were performed through the left posterior thoracotomy at fourth intercostal space. Twenty two (31.5%) newborns with CoA underwent resection and extended end-to-end anastomosis between descending aortic and aortic arch. Thirty (42.8%) newborns had CoA, DAAH and septal defects. Ten of theme had PA banding, at first they had modified Amato distal aortic arch plasty. In 2 years after operation revealed significant growth of the aortic arch of 45 patiets. Median sizes of aortic arch segments were “А” — (9.80±0.54) mm (Z-score 0.45); “В” — (9.20±0.34) mm (Z-score 0.53); “С” — (10.1±0.4) mm (Z-score 0.35). The total period of observation for patients was more than 10 years. 68 (97.2%) patients underwent surgery well. Lethality was 2.8%.