Predictors for Reintervention after Surgical Coarctation Repair through Left Thoracotomy | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 119, Volume 83, Issue 1, April 2021, Page 1589-1596 PDF (444.92 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2021.171409 | ||||
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| Authors | ||||
Ayman R Abdelrehim1; Rafik Fekry Barsoom Soliman   2; Luna S Baangood3; Saad Q Khoshhal3
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| 1Cardiothoracic Surgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt. | ||||
| 2Cardiothoracic Surgery department, Faculty of medicine, Menoufia University | ||||
| 3Pediatric Cardiology Department, Madina Cardiac Center, Madina, Saudi Arabia | ||||
| 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 | ||||
| Keywords | ||||
| Aortic coarctation; Infant; Outcome; Recurrence; Risk factors | ||||
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