Abstract: ObjectiveTo explore the clinical experiences of surgical treatments for coarctation of aorta(COA) with intracardiac anomalies and pulmonary arterial hypertension (PAH) in infants.MethodsA retrospective casecontrol study was carried out in 36 infants operated in our hospital during February 2012 to February 2017. There were 16 cases with COA and PAH in group A, and 20 cases with ventricular septal defect(VSD) and PAH in group B. The perioperative clinical data and followup data of the two groups were compared.ResultsAll the patients were operated by both arch repair and intracardiac anomalies repair completed via sternotomy under extracorporeal circulation in singlestage. There was no significant difference of the mean pulmonary arterial pressure preoperatively between the two groups（P>0.05）. By the end of extracorporeal circulation, the mean pulmonary arterial pressure of group A was （28.4±8.8） mmHg（1mmHg=0.133 kPa）, which was higher than （21.2±5.0 ）mmHg of group B（P<0.05）. It was longer in extracorporeal circulation time, aortic block time and postoperative ventilator aeration time of group A（P<0.05）. There was no mortality, nor paraplegia after operation. The postoperative arterial pressure gradient between the upper and the lower extremities was less than 10 mmHg, and no PAH was found under ultrasound detection 3 months after operation.ConclusionsIt would turn a rapider deteriorate in infants of COA and left to right shunt combined with PAH. It may get satisfactory effect if correction of the heart malformation and relief of COA could achieve in time.
周文武，伍明，陈飞，侯安新，周庆，张志功，杨劲松. 婴幼儿主动脉缩窄合并心内畸形及肺动脉高压的外科治疗[J]. 中国现代手术学杂志, 2017, 21(5): 357-360.
ZHOU Wen-wu, WU Ming, CHEN Fei, HOU An-xin, ZHOU Qing, ZHANG Zhi-gong, YANG Jing-song. Singlestage Correction of Coarctation of Aorta with Intracardiac Anomalies and Pulmonary Arterial Hypertension in Infants. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 357-360.
Callahan C, Saudek D, Shillingford A, et al. Singlestage repair of coarctation of the aorta and ventricular septal defect: a comparison of surgical strategies and resource utilization［J］. World J Pediatr Congenit Heart Surg, 2017,8(5):559563. doi: 10.1177/2150135117727256.
Luo K, Zheng J, Wang S, et al. Singlestage correction for taussigbing anomaly associated with aortic arch obstruction［J］. Pediatr Cardiol, 2017,38(8):15481555. doi: 10.1007/s0024601716946.
2017, Vol. 21 
