title: The effect of aortic coarctation surgical repair on QTc and JTc dispersion in severe aortic coarctation newborns: a short-term follow-up study.
abstract: Sudden death is a possible occurrence for newborns younger than 1 year with severe aortic coarctation (CoA) before surgical correction. In our previous study, we showed a significant increase of QTc-D and JTc-D in newborns with isolated severe aortic coarctation, electrocardiographic parameters that clinical and experimental studies have suggested could reflect the physiological variability of regional and ventricular repolarization and could provide a substrate for life-threatening ventricular arrhythmias. The aim of the current study was to evaluate the effect of surgical repair of CoA on QTc-d, JTc-d in severe aortic coarctation newborns with no associated congenital cardiac malformations. The study included 30 newborns (18M; 70+/-12 h old) affected by severe congenital aortic coarctation, without associated cardiac malformations. All newborns underwent to classic extended end-to-end repair. Echocardiographic and electrocardiographic measurements were performed in each patient 24 h before and 24 h after the interventional procedure and at the end of the follow-up period, 1 month after the surgical correction. All patients at baseline, 24 h and one month after CoA surgical repair did not significantly differ in terms of heart rate, weight, height, and echocardiographic parameters. There were no statistically significant differences in QTc-D (111.7+/-47.4 vs 111.9+/-63.8 ms vs 108.5+/-55.4 ms; P=0.4) and JTc-D (98.1+/-41.3 vs 111.4+/-47.5 vs 105.1+/-33.4 ms; P=0.3) before, 24 h and 1 month after CoA surgical correction. In conclusions, our study did not show a statistically significant decrease in QTc-D and JTc-D, suggesting the hypothesis that the acute left ventricular afterload reduction, related to successful CoA surgical correction, may not reduce the ventricular electrical instability in the short-term follow-up.
authors.affiliation: Chair of Cardiology, Second University of Naples, Naples, Italy.andreaantoniopapa@libero.it.
authors.forename: G
authors.initials: G
authors.lastname: Nigro
authors.forename: V
authors.initials: V
authors.lastname: Russo
authors.forename: A
authors.initials: A
authors.lastname: Rago
authors.forename: A A
authors.initials: AA
authors.lastname: Papa
authors.forename: N D
authors.initials: ND
authors.lastname: Cioppa
authors.forename: C
authors.initials: C
authors.lastname: Scarpati
authors.forename: T
authors.initials: T
authors.lastname: Palladino
authors.forename: A
authors.initials: A
authors.lastname: Corcione
authors.forename: B
authors.initials: B
authors.lastname: Sarubbi
authors.forename: G
authors.initials: G
authors.lastname: Caianiello
authors.forename: M G
authors.initials: MG
authors.lastname: Russo
mesh_terms: D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography