Results of using cardiopulmonary bypass for spinal cord protection during surgical repair of complex aortic coarctation
- 7 February 2013
- journal article
- research article
- Published by Cambridge University Press (CUP) in Cardiology in the Young
- Vol. 24 (1), 113-119
- https://doi.org/10.1017/s1047951113000115
Abstract
Background The aim of this study was to evaluate the surgical treatment of complex aortic coarctation using partial cardiopulmonary bypass to increase the spinal cord protection. Methods A total of 15 patients (age range from 7 to 48 years) underwent coarctation repair through a left posterolateral thoracotomy with cardiopulmonary bypass. Cannulation was performed via the descending aorta and the main pulmonary artery. In all, six surgeries were performed under hypothermic circulatory arrest and nine repairs were performed under mild hypothermia. The clinical outcome regarding the development of restenosis, as well as major neurologic complication, was studied. Results There was no mortality. None of the patients developed paraplegia. Of the 15 patients, two developed a recurrent stenosis at the proximal anastomosis between the aortic arch and the aortic prothesis at a mean follow-up of 5.5 years. In the remaining 13 patients, echocardiography and magnetic resonance imaging showed no evidence of a significant gradient. Conclusion Complex aortic coarctation without hypoplasia of the proximal aortic arch and intra-cardiac anomalies can be repaired with low mortality and neurologic morbidity via a left thoracotomy using cardiopulmonary bypass. The use of cardiopulmonary bypass goes along with a low risk of spinal cord and lower body ischaemia and provides a sufficient amount of time for the anastomoses.Keywords
This publication has 1 reference indexed in Scilit:
- Surgical treatment of aortic coarctation in infants younger than three months: 1985 to 1990The Journal of Thoracic and Cardiovascular Surgery, 1994