Long-term evolution of aortic arch interruption repair with pulmonary artery autograft - 14/08/21
Résumé |
Backgrounds |
Surgical correction of the aortic arch interruption (IAA) is regularly complicated by anastomosis stenosis or the long-term occurrence of arterial hypertension. In order to prevent these complications, a new surgical technique has been developed in our center consisting of the interposition of a segment of the main pulmonary artery to enlarge the aortic anastomosis. The purpose of this study was to assess the 10years outcome of this intervention.
Methods |
Four children undergoing this surgery with a follow-up over 10years were retrospectively included. Data collected focused on the last measure of blood pressure (BP), the last echocardiographic evaluation, and the aortic arch dimension on the last CT.
Results |
The whole patients had IAA type B and 22q11 microdeletion. The median follow-up duration was 13.9years (range: 9.3 to 15.3). None of them had a new surgery of the aortic arch, but one need enlargement of ascending aorta. Only one patient developed a mild restenosis at the isthmic insertion of the pulmonary autograft [Z score −2.7 at CT (Fig. 1 C)], responsible of mild arterial hypertension (systolic BP 75th percentile, diastolic BP 98th percentile), and a left ventricle hypertrophy (Z score IVSd 2.5, Z Score LVPWd 2.1). The three others patients displayed normal BP, no left ventricular hypertrophy, no significant aortic arch obstruction on Doppler evaluation and minimum Z score of aortic arch at CT from −1.8 to −0.4 (Fig. 1A, B, D). None of them did experience a main pulmonary artery stenosis.
Conclusion |
Reconstruction of the aortic arch with a pulmonary artery autograft for the correction of IAA provides a good long-term result.
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Vol 13 - N° 4
P. 302 - septembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.