One-stage repair of aortic coarctation combined with cardiac anomalies and severe pneumonia_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAO Junping ,  WANG Jianming , WEN Linlin , JIN Lichen , ZHANG Xuejie

Department of Cardiac Surgery, Children’s Hospital of Hebei Province, Shijiazhuang, 050030, P.R.China;

Corresponding author：

WANG Jianming, Email: 18610040424@163.com

Keywords：

Aortic coarctation; cardiac anomalies; severe pneumonia; one-stage repair

DOI：

10.7507/1007-4848.201603053

Video：

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Objective To analyze the clinical outcome of one-stage repair of aortic coarctation combined with cardiac anomalies and pneumonia. Methods We retrospectively reviewed the clinical data of 26 patients with severe pneumonia undergoing repair of aortic coartation between January 2014 and August 2015, among whom 7 patients (26.9%) received tracheal intubation, 5 patients double incision, and 21 patients single incision. Long-term follow-up results were obtained from outpatient department. Results Two patients died from operations. The mean hospital stay was 18.5±4.5 d, bypass time 93.5±36.4 min, and mechanical ventilation time 89.5±41.3 min. Postoperative complication mainly was pneumonia. During 6-month follow-up at outpatient department, incidence of pneumonia decreased, and children’s growth and development remarkably improved. Conclusion In the case of uncontrollable pneumonia, one-stage repair of aortic coarctation associated with cardiac anomalies still can receive a good outcome.

Citation： YAO Junping, WANG Jianming, WEN Linlin, JIN Lichen, ZHANG Xuejie. One-stage repair of aortic coarctation combined with cardiac anomalies and severe pneumonia. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(8): 594-597. doi: 10.7507/1007-4848.201603053 Copy

1.	Korbmacher B, Krogmann ON, Rammos S, et al. Repair of critical aortic coartation in neonatal age. J Cardiovasc Surg, 2002, 43(1): 1-6.
2.	Acevedo-Bañuelos I, González-Peña J, Chagolla-Santillán MÁ, et al. Surgery repair of aortic coarctation in infancy. Arch Cardiol Mex, 2013, 83(3): 159-164.
3.	Suarez de Lezo J, Pan M, Romero M, et al. Percutaneous interventions on severe coarctation of the aorta, a 21 year experience. Pediatr Cardiol, 2005, 26(2): 176-189.
4.	Jonas RA. Management of interrupted aortic arch. Semin Thorac Cardiovasc Surg, 2015, 27(2): 177-188.
5.	Thomson JD, Mulpur A, Guerrero R, et al. Outcome after extended arch repair for aortic coarctation. Heart, 2006, 92(1): 90-94.
6.	Wright GE, Nowak CA, Goldberg CS, et al. Extended resection and end-to-end anastomosis for aortic coarctation in infants: results of a tailored surgical approach. Ann Thorac Surg, 2005, 80(4): 1453-1459.
7.	鲁亚南, 刘锦纷, 徐志伟, 等. 主动脉弓补片成形术治疗婴幼儿主动脉缩窄合并主动脉弓发育不良. 中国胸心血管外科临床杂志, 2010, 17(6): 455-458.
8.	陶曙光, 王建明, 杨仕海, 等. 婴幼儿主动脉缩窄合并心内畸形 Ⅰ 期手术治. 心肺血管病杂志, 2012, 31(5): 534-539.
9.	Bigdelian H, Sedighi M. Repair of aortic coarctation in infancy: A 10-year clinical experience. Asian Cardiovasc Thorac Ann, 2016, 15(2): 229-231.
10.	Bhatt M, Roth SJ, Kumar RK, et al. Management of infants with large unrepaired ventricular septal defects and respiratory infection requiring mechanical ventilation. Thorac Cardiovac Surg, 2004, 127(5): 1466-1473.
11.	Nseir S, Povoa P, Salluh J, et al. Is there a continuum between ventilator-associated tracheobronchitis and ventilator-associated pneumonia? Intensive Care Med, 2016, 14(1): 278-282.
12.	张金洲, 朱海龙, 孙国成, 等. 婴幼儿主动脉缩窄合并心脏畸形的外科治疗. 中国胸心血管外科临床杂志, 2008, 15(1): 14-16.
13.	Kanter KR, Mahle WT, Kogon BE, et al. What is the optimal management of infants with coaretation and ventricular septal defect? Ann Thorac Surg, 2007, 84(2): 612-618.
14.	周智恩, 王道庄, 何伦德, 等. 小儿主动脉缩窄合并心内畸形的治疗. 中国胸心血管外科临床杂志, 2011, 18(4): 382.
15.	Waiters HL 3rd, lonan CE, Thomas RL, et al. Technique of single-stage repair of coarctation of the aorta with ventricular septal defect. Semi Thorac Cardiovasc Surg Pediatr Card Surg Ann, 2008, 1(1): 22-30.
16.	Turkoz R, Saritas B, Ozker E, et al. Selective cerebral perfusion with aortic cannulation and short-term hypothermic circulatory arrestin aortic arch reconstruction. Perfusion, 2014, 29(1): 70-74.
17.	Adler AL, Smith J, Permut LC, et al. Significance of positive mediastinal cultures in pediatric cardiovascular surgical procedure patients undergoing delayed sternal closure. Ann Thorac Surg, 2014, 98(2): 685-690.
18.	Spiliopoulos S, Autschbach R, Koerfer R, et al. Delayed sternal closure after total artificial heart implantation. J Thorac Cardiovasc Surg, 2015, 150(2): 417-418.
19.	Konstantinov IE. Does peritoneal dialysis improve outcomes after heart surgery in infants? J Thorac Cardiovasc Surg, 2015, 149(1): 237-238.
20.	Jang WS, Kim WH, Choi K, et al. Incidence, risk factors and clinical outcomes for acute kidney injury after aortic arch repair in paediatric patients. Eur J Cardiothorac Surg, 2014, 45(6): e208-e214.

1. Korbmacher B, Krogmann ON, Rammos S, et al. Repair of critical aortic coartation in neonatal age. J Cardiovasc Surg, 2002, 43(1): 1-6.
2. Acevedo-Bañuelos I, González-Peña J, Chagolla-Santillán MÁ, et al. Surgery repair of aortic coarctation in infancy. Arch Cardiol Mex, 2013, 83(3): 159-164.
3. Suarez de Lezo J, Pan M, Romero M, et al. Percutaneous interventions on severe coarctation of the aorta, a 21 year experience. Pediatr Cardiol, 2005, 26(2): 176-189.
4. Jonas RA. Management of interrupted aortic arch. Semin Thorac Cardiovasc Surg, 2015, 27(2): 177-188.
5. Thomson JD, Mulpur A, Guerrero R, et al. Outcome after extended arch repair for aortic coarctation. Heart, 2006, 92(1): 90-94.
6. Wright GE, Nowak CA, Goldberg CS, et al. Extended resection and end-to-end anastomosis for aortic coarctation in infants: results of a tailored surgical approach. Ann Thorac Surg, 2005, 80(4): 1453-1459.
7. 鲁亚南, 刘锦纷, 徐志伟, 等. 主动脉弓补片成形术治疗婴幼儿主动脉缩窄合并主动脉弓发育不良. 中国胸心血管外科临床杂志, 2010, 17(6): 455-458.
8. 陶曙光, 王建明, 杨仕海, 等. 婴幼儿主动脉缩窄合并心内畸形 Ⅰ 期手术治. 心肺血管病杂志, 2012, 31(5): 534-539.
9. Bigdelian H, Sedighi M. Repair of aortic coarctation in infancy: A 10-year clinical experience. Asian Cardiovasc Thorac Ann, 2016, 15(2): 229-231.
10. Bhatt M, Roth SJ, Kumar RK, et al. Management of infants with large unrepaired ventricular septal defects and respiratory infection requiring mechanical ventilation. Thorac Cardiovac Surg, 2004, 127(5): 1466-1473.
11. Nseir S, Povoa P, Salluh J, et al. Is there a continuum between ventilator-associated tracheobronchitis and ventilator-associated pneumonia? Intensive Care Med, 2016, 14(1): 278-282.
12. 张金洲, 朱海龙, 孙国成, 等. 婴幼儿主动脉缩窄合并心脏畸形的外科治疗. 中国胸心血管外科临床杂志, 2008, 15(1): 14-16.
13. Kanter KR, Mahle WT, Kogon BE, et al. What is the optimal management of infants with coaretation and ventricular septal defect? Ann Thorac Surg, 2007, 84(2): 612-618.
14. 周智恩, 王道庄, 何伦德, 等. 小儿主动脉缩窄合并心内畸形的治疗. 中国胸心血管外科临床杂志, 2011, 18(4): 382.
15. Waiters HL 3rd, lonan CE, Thomas RL, et al. Technique of single-stage repair of coarctation of the aorta with ventricular septal defect. Semi Thorac Cardiovasc Surg Pediatr Card Surg Ann, 2008, 1(1): 22-30.
16. Turkoz R, Saritas B, Ozker E, et al. Selective cerebral perfusion with aortic cannulation and short-term hypothermic circulatory arrestin aortic arch reconstruction. Perfusion, 2014, 29(1): 70-74.
17. Adler AL, Smith J, Permut LC, et al. Significance of positive mediastinal cultures in pediatric cardiovascular surgical procedure patients undergoing delayed sternal closure. Ann Thorac Surg, 2014, 98(2): 685-690.
18. Spiliopoulos S, Autschbach R, Koerfer R, et al. Delayed sternal closure after total artificial heart implantation. J Thorac Cardiovasc Surg, 2015, 150(2): 417-418.
19. Konstantinov IE. Does peritoneal dialysis improve outcomes after heart surgery in infants? J Thorac Cardiovasc Surg, 2015, 149(1): 237-238.
20. Jang WS, Kim WH, Choi K, et al. Incidence, risk factors and clinical outcomes for acute kidney injury after aortic arch repair in paediatric patients. Eur J Cardiothorac Surg, 2014, 45(6): e208-e214.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

One-stage repair of aortic coarctation combined with cardiac anomalies and severe pneumonia

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