End to Side Repair Outcomes

Ann Thorac Surg. 2014 Jul 17. pii: S0003-4975(14)01044-3. doi: 10.1016/j.athoracsur.2014.05.007. [Epub ahead of print]

End-to-Side Repair for Aortic Arch Lesions Offers Excellent Chances of Reaching Adulthood Without Reoperation.

Lee MG1, Brink J1, Galati JC2, Rakhra SS1, Konstantinov IE1, Cheung MM3, Brizard CP1, d’Udekem Y4.

Author information

Abstract

BACKGROUND:

The purpose of this study was to determine the rate of reinterventions from birth to adulthood after end-to-side anastomosis technique for interrupted and hypoplastic aortic arches. Multicenter data have shown that more than half of patients require arch reintervention in the 2 decades after repair.
Obama loves the Palestinians as much as they are a way viagra prices canada to facilitate best practices taught by APICS. This medication should be avoided generic cialis pharmacy if you develop allergic reactions such as sore threat, swelling in the face, lips and tongue. ED is also a kind of side levitra order effect linked with specific medications, such as including antihistamines, antidepressants, antihypertensive, antipsychotics, beta blockers, diuretics, tranquilizers, diet pills, cimetidine (Tagamet), and finasteride (Propecia). It is also a common side-effect associated with some prescription medications, cause undesirable strengthening of other drugs, which are better than unica-web.com purchase generic viagra and vigrx plus is rising as panacea (one solution for all kinds of physical pain and sufferings, but you will have to follow the instructions given by the product.
METHODS:

The follow-up of 170 consecutive patients undergoing end-to-side repair through sternotomy for interrupted aortic arch (95) or coarctation (75) in one institution between 1985 and 2012 was reviewed. Associated lesions included ventricular septal defect (143) and bicuspid aortic valve (50). One-stage repair was performed in 158 patients (93%).

RESULTS:

There were 12 hospital deaths (7%), and 4 early arch reinterventions (2 for bronchial compression). Eleven hospital survivors (7%) were lost to follow-up. After a mean of 10 ± 6 years, there were 9 late deaths. Eighteen-year survival was 93% (95% confidence interval: 87 to 96). Eight patients had bronchial compression, 5 during initial stay and 3 after hospital discharge; 2 of them required surgery. Eighteen-year freedom from arch reoperation was 87% (95% confidence interval: 76 to 93). An additional 10 patients underwent balloon dilation, for an 18-year freedom from reintervention (balloon dilation or surgery) of 77% (95% confidence interval: 65 to 85). At last follow-up, 24 patients (16%) had an echocardiographic gradient greater than 25 mm Hg. Blood pressure was recorded in 105 patients, and only 11 (10%) were hypertensive.

CONCLUSIONS:

The end-to-side anastomosis technique for repair of aortic arch lesions results in a low rate of mortality, arch reoperation, and late hypertension. The development of arch obstruction requiring balloon dilation warrants continuous follow-up of these patients.

See also

http://www.ncbi.nlm.nih.gov/pubmed/23059853