儿童主动脉瓣狭窄评估:单中心经验

IF 1.3 Q3 PEDIATRICS
Hasan Türkmen, Fahrettin Uysal, Abdüsselam Genç, Özlem M Bostan, Işık Şenkaya Siğnak
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引用次数: 0

摘要

主动脉共动脉症(CoA)占儿童先天性心脏病的 3.5%。临床表现从心力衰竭到无症状高血压不等。治疗方法包括手术修复、球囊血管成形术和支架植入术。我们的目的是调查手术和球囊血管成形术的长期效果,以确定再梗塞的可能风险因素以及与治疗方法早期成功相关的预测因素。我们评估了2015年至2020年期间在一家三级中心接受检查并确诊为CoA的138名儿童的数据。对患者的基本人口统计学特征、临床和超声心动图检查结果、治疗结果和治疗方法进行了回顾性评估。平均随访时间为 75.1 个月(1-223 个月)。作为初始治疗,75 名患者(60.5%)接受了球囊血管成形术,44 名患者(35.5%)接受了手术,5 名患者(4%)接受了支架植入术。球囊血管成形术和手术的早期成功率分别为 72.5% 和 79.5%。47.6%的患者在首次治疗后出现再梗塞。所有患者的中位无再梗塞生存时间为138个月,手术组明显更长(P = .025)。手术组患者的再梗阻率略低于接受球囊血管成形术的患者,但没有统计学意义。临床和超声心动图检查结果均未发现与再梗塞或早期成功有关。在主动脉粥样硬化治疗后的长期随访中,再椎管狭窄的发生率仍然很高,临床和超声心动图检查结果不足以预测早期成功的几率和再椎管狭窄的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Children with Aortic Coarctation: A Single-Center Experience.

Coarctation of the aorta (CoA) accounts for 3.5% of all congenital heart diseases in children. The clinical manifestations range from heart failure to asymptomatic hypertension. Treatment options include surgical repair, balloon angioplasty, and stenting. We aimed to investigate the long-term results of surgery and balloon angioplasty to identify the possible risk factors for recoarctation and predictors associated with early success in treatment modalities. The data of 138 children who underwent examinations at a tertiary center between 2015 and 2020 with the diagnosis of CoA were evaluated. The basic demographic characteristics, clinical and echocardiographic findings, results, and treatment methods of the patients were evaluated retrospectively. The mean follow-up period was 75.1 months (range of 1-223). As initial treatment, 75 patients (60.5%) underwent balloon angioplasty, 44 (35.5%) underwent surgery, and 5 (4%) underwent stenting. The early success rate of balloon angioplasty and surgery was 72.5% and 79.5%, respectively. Recoarctation occurred in 47.6% of patients following the first therapy. The median reintervention-free survival time was 138 months for all patients and was significantly higher in the surgery group (P = .025). The recoarctation rate was slightly lower in the surgery group than in those who underwent balloon angioplasty, but it was not statistically significant. None of the clinical and echocardiographic findings were found to be associated with recoarctation or early success. The rate of recoarctation is still high in long-term follow-up after aortic coarctation treatment, and clinical and echocardiographic findings are insufficient to predict the chance of early success and the risk of recoarctation.

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