Comparison of Sternotomy Access Versus Thoracotomy Access in the Surgical Treatment of Aortic Coarctation: A Propensity Score-matched Study.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of the Saudi Heart Association Pub Date : 2024-10-13 eCollection Date: 2024-01-01 DOI:10.37616/2212-5043.1396
Ilya A Soynov, Ksenya A Rzayeva, Yuriy N Gorbatykh, Yuriy Y Kulyabin, Artem V Gorbatykh, Ilya A Velyukhanov, Nataliya R Nichay, Serezha N Manukian, Saihuna A Magbulova, Aleksey N Arkhipov, Aleksander V Bogachev-Prokophiev
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引用次数: 0

Abstract

Background: The search for the "Holy Grail" of surgical repair for aortic coarctation involves finding an access and correction method that successfully and consistently avoids aortic recoarctation and arterial hypertension. The controversy persists as there is still no consensus on the best surgical approach and technique to achieve these objectives.

Objective: The objective of this study is to compare sternotomy and left thoracotomy as surgical techniques for treating patients with aortic coarctation and hypoplasia of the distal aortic arch.

Methods: From January 2008 to December 2020, 103 surgical procedures were performed using an extended oblique anastomosis. The patients were divided into 2 groups: oblique, extended anastomosis from thoracotomy access (n-68; 66%) and oblique extended anastomosis from sternotomy access (n-35; 34%). After performing a propensity score analysis (1:1) for the entire sample, 25 patients from sternotomy access were matched with 25 patients from thoracotomy access.

Results: The mortality rate in the thoracotomy group was 4%, with 1 patient, while it was 8% with 2 patients in the sternotomy group, p > 0.99. There were no significant differences in early postoperative complications between the two groups. Recurrence of aortic coarctation was observed more frequently in the thoracotomy group (20.8% vs 0%). Low weight was identified as the only risk factor for aortic re-coarctation.

Conclusion: The mortality rates and early postoperative complications associated with the surgical repair of aortic coarctation were similar between the sternotomy and thoracotomy approaches. Nevertheless, sternotomy approach may be beneficial in reducing aortic recoarctation.

在主动脉粥样硬化的手术治疗中,鞘膜切开术入路与胸廓切开术入路的比较:倾向评分匹配研究
背景:寻找主动脉粥样硬化手术修复的 "圣杯",包括找到一种能够成功且持续避免主动脉再梗阻和动脉高血压的入路和矫正方法。由于对实现这些目标的最佳手术方法和技术仍未达成共识,因此争议一直存在:本研究旨在比较胸骨切开术和左胸廓切开术作为治疗主动脉瓣闭锁和主动脉弓远端发育不良患者的手术技术:方法:2008年1月至2020年12月,103例手术采用了扩展斜吻合术。患者分为两组:从胸廓切开术入路进行斜行扩展吻合术(n-68;66%)和从胸骨切开术入路进行斜行扩展吻合术(n-35;34%)。在对整个样本进行倾向评分分析(1:1)后,25 名胸骨切开术入路的患者与 25 名胸廓切开术入路的患者进行了配对:结果:胸廓切开术组的死亡率为 4%,其中 1 名患者死亡,而胸骨切开术组的死亡率为 8%,其中 2 名患者死亡,P > 0.99。两组患者术后早期并发症无明显差异。胸廓切开术组的主动脉缩窄复发率更高(20.8% 对 0%)。体重过轻是主动脉再狭窄的唯一风险因素:结论:胸骨切开术和胸廓切开术手术修复主动脉缩窄的死亡率和术后早期并发症相似。尽管如此,胸骨切开术可能有利于减少主动脉再梗塞。
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来源期刊
Journal of the Saudi Heart Association
Journal of the Saudi Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
0.00%
发文量
30
审稿时长
15 weeks
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