Surgical treatment and Interventional catheterization of newborns and infants with native aortic coarctation

Fernando Frías Grishko, Luis E. Marcano Sanz, Obdulio González Hernández, Eugenio Selman-Houssein Sosa, José A. Seijas Cruz, Juan C. Ramiro Novoa
2014 Revista cubana de cardiología y cirugía cardiovascular  
Surgical relief of Coarctation of the aorta (CoA) and catheter interventional techniques are available alternatives even though no consensus has been reached in regard to the method of intervention (surgery vs. balloon angioplasty) in neonates and infants with native CoA. Many cardiologists prefer surgical intervention, whereas a few may choose for balloon angioplasty. Objective: To analyze surgical and interventional techniques outcomes in neonates and infants with native CoA. To identify the
more » ... A. To identify the complications and the intensive care unit (ICU) stays. To determine the risk factors related to recoarctation (ReCoA). Method: An observational, analytical, longitudinal and prospective study was made aiming to analyze the surgical and balloon angioplasty outcomes in newborns and infants with native CoA at the William Soler Pediatric Cardiology Hospital from 2006 - 2011. Patients were distributed in two groups: Group I: patients treated with surgery (n=50); Group II: patients treated with angioplasty (n=14). Results: 75.0 % of patients in Group I and 57.1 % of the Group II were less than the six months old. ICU stays of patients treated surgically were the largest (median of 36 hours). The percentage of ReCoA was higher in patients treated with angioplasty (28.5 %). Paradoxical arterial hypertension was the most common complication found (60.0 %). A residual gradient higher than 15 mm Hg following surgical correction or balloon angioplasty was identified as a risk factor for ReCoA (interventional catheterization RR: 7.5; surgery RR: 11.4). Conclusions: ICU stays were longer in the patients underwent surgery. Patients treated with balloon angioplasty showed higher incidence of ReCoA. Complications were not so frequent. A gradient higher than 15 mm Hg was identified as a risk factor for ReCoA irrespective of the procedure performed.
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