Clinical & Experimental Cardiology
Open Access

Surgery of aortic coarctation: About 40 cases

15^th World Cardiac Surgery & Angiology Conference

December 08-09, 2016 Philadelphia, USA

Lakehal Redha, Boukarroucha Radouane, Aimer Farid, Bouharagua Rabeh, Gueriti Fateh, Bellara Radouane, Nazzel Rafik, Amros Amine, Cherif Samiha, Massikh Nadjet, Aziza Baya, Bendjaballah Soumaya and Brahami Abdelmallek

Constantine University, Algeria

Posters & Accepted Abstracts: J Clin Exp Cardiolog

Abstract :

Introduction: Coarctation was defined if aortic diameter was reduced to 50% or more compared with the diaphragmatic aorta, hypertension in the upper extremity at or beyond the 95th percentile for age and gender, symptoms of associated distal ischemia, or an arm/leg gradient at rest of 50 mm Hg or more. The optimal method of coarctation repair in the infant is excision with primary extended end-to-end anastomosis; in adolescent and young adults still not been defined. There is no consensus in the literature regarding the optimal method for repair of coarctation of the aorta in the adolescent and young adult. Paraplegia is a devastating complication of coarctation of the aorta repair in patients with inadequate collaterals. Methods: Between 2001 and 2016, there were 40 adolescents and adults between the ages of 4 and 46 years (mean age 20, years); weight: 17 to 96 kg, the surgery was done in majority without cardiopulmonary bypass (â�?�?clamp-and-sewâ�? technique), only four patients underwent coarctation with CPB (femoral-femoral bypass); the diagnostic of coarctation was made by echocardiographic Doppler and CT tomography in all patients; the correction consisted in all patients in excision stenotic portion with interposition prosthetic grafts. Results: The perioperative mortality rate was 02.7% (one patient: renal failure) and the morbidity rate was 13.5% (five patients). Stay in the USI varied from one to 24 days with a mean of nine days. The time from operation to discharge varied from eight to 60 days, with a mean of 15 days. Mean fellow up was of 59 months (range, 3 to 116 months); the late mortality was 0%. Conclusion: Surgical repair of coarctation of the aorta in the adolescent and adult is safe and durable, various techniques are utilized (end to end anastomosis, prosthetic substitute and endocascular reparation). A successful surgical repair is defined by success rate in curing patients of hypertension, relieves symptoms and restores visceral and peripheral perfusion pressure, without recurrence of the coarctationor aneurysmal development around the repair site. Paraplegia is a serious complication in post operative; the prevention should be the major concern of surgeon during the surgical repair of the coarctation.

Biography :

Email: lakehal.redha@gmail.com