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171409

Predictors for Reintervention after Surgical Coarctation Repair through Left Thoracotomy

Article

Last updated: 24 Dec 2024

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Abstract

Background: Recoarctationof the aorta may occur in infants after the primary surgical repair. Several risk factors were suggested in the literature, with controversial results among the studies. Objective: This study was conducted to evaluate the predictors for reintervention after surgical coarctation repair by different techniques through left thoracotomy. Patients and Methods: A retrospective analysis was performed for patients who underwent isolated surgical coarctation repair or with pulmonary artery band between Sep 2014 and December 2018. All primary intervention was through thoracotomy. Reintervention was defined as the need for balloon angioplasty or reoperation. Results: A total of 47 patients with median age at repair of 7 days. The median duration of follow-up was 18 months (95% CI=14 to 22 months). Only 7 (14.9%) patients required reintervention. No mortality was recorded during the follow-up period. Cox proportional hazard analysis showed that only postoperative pressure gradient was an independent risk factor for reintervention. Receiver operating characteristic curve showed that postoperative pressure gradient was an excellent indicator (AUC = 0.948, 95% CI: 0.841 to 0.992, p < 0.001), with the optimal cut-off value >25, sensitivity of 100% and specificity of 80%. Conclusions: Repair of aortic coarctation through thoracotomy has an overall good outcome. However, reintervention is required in some patients and elevated pressure gradient on echocardiographic assessment <25 can exclude recoarctation

DOI

10.21608/ejhm.2021.171409

Keywords

Aortic coarctation, infant, Outcome, Recurrence, risk factors

Authors

First Name

Ayman R

Last Name

Abdelrehim

MiddleName

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Affiliation

Cardiothoracic Surgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.

Email

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City

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Orcid

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First Name

Rafik

Last Name

Soliman

MiddleName

Fekry Barsoom

Affiliation

Cardiothoracic Surgery department, Faculty of medicine, Menoufia University

Email

rafikfekry@hotmail.com

City

Cairo

Orcid

0000-0002-6931-4695

First Name

Luna S

Last Name

Baangood

MiddleName

-

Affiliation

Pediatric Cardiology Department, Madina Cardiac Center, Madina, Saudi Arabia

Email

-

City

-

Orcid

-

First Name

Saad Q

Last Name

Khoshhal

MiddleName

-

Affiliation

Pediatric Cardiology Department, Madina Cardiac Center, Madina, Saudi Arabia

Email

-

City

-

Orcid

-

Volume

83

Article Issue

1

Related Issue

23025

Issue Date

2021-04-01

Receive Date

2021-05-23

Publish Date

2021-04-01

Page Start

1,589

Page End

1,596

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_171409.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=171409

Order

119

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Predictors for Reintervention after Surgical Coarctation Repair through Left Thoracotomy

Details

Type

Article

Created At

22 Jan 2023