A comparison of balloon angioplasty of native coarctation versus surgical repair for short segment coarctation associated with ventricular septal defect-a single-center retrospective review of 92 cases.
BACKGROUND
The hybrid technique combining balloon angioplasty for discrete coarctation (CoA) and surgical repair of a ventricular septal defect (VSD) is a novel treatment for patients with aortic CoA and VSD, but the efficacy of this approach is unknown.


METHODS
We performed a retrospective analysis of 92 patients with short segment CoA and VSD who underwent complete repair between January 2004 and July 2014 in our center. Patients were divided into two groups according to the surgical approach employed: hybrid procedure (group A, n=39) and traditional midline surgical repair (group B, n=53). Baseline, perioperative, and outcome data were compared between the two groups.


RESULTS
Three early deaths occurred in group B, whereas none occurred in group A. Compared to those in group B, patients in group A experienced a shorter aortic clamp duration (28.1±6.7 vs. 43.2±9.2 minutes, P<0.001), shorter cardiopulmonary bypass (CPB) duration (52.9±10.7 vs. 86.2±23.8 minutes, P<0.001), shorter ventilator time (47.0 vs. 73.7 hours, P=0.002), and shorter intensive care unit stay (6.2 vs. 9.1 days, P=0.019). The risks for aortic re-CoA and re-intervention did not differ significantly between the groups within five years (P=0.40 and 0.65, respectively).


CONCLUSIONS
The hybrid technique was associated with better periprocedural outcomes for patients with short-segment CoA and VSD. The incidences of aortic re-CoA and re-intervention were comparable between the hybrid technique and surgical groups over a mid-term follow-up.
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Huifeng
H
Zhang
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Ming
M
Ye
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Gang
G
Chen
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Fang
F
Liu
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Lin
L
Wu
Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 200000, China.
Bing
B
Jia
Aortic operation; cerebral protection; coarctation (CoA); minimally invasive surgery