Aortic coarctation risk factors for re-intervention following surgery: back-end research in childhood aortic coarctation

''Aortic Coarctation: Risk Factors for Re-Intervention Following Surgery: Back-end Research in Childhood Aortic Coarctation Patients'' Object: Investigation of risk factors for recoarctation in patients undergoing surgical intervention for aortic coarctation (AoC) Materials and Methods: Data of 100 patients who were operated for AoC between January 2005 and December 2017 were retrospectively reviewed. Patients under 18 years of age who underwent surgical treatment for AoC were included in the study. Patients with follow-up for at least nine months were included in the study.After the data of the patients were screened, other than demographic factors such as body weight, age and accompanying cardiac and aortic pathology, the operation technique, additional procedures and the effect of ischemia duration on recoarctation were investigated. The number of patients and their associated cardiac pathologies were investigated. Results: The mean age of the patients in the study was 134 ± 412 (1-2950) and the mean body weight was 4.6 ± 2.73 (1.1-20.9) kg. 30 patients (30%) Isolated AoC, 28 (28%) patients with Ventricular Septal defecation (VSD) AoC, 42 (42%) Complex Cardiac pathology together with AoC diagnosis of 47 (47%) patients resection end-to-end anostomosis, 4 patients (4%) underwent surgical repair with patch and aortoplasty, 49 (49%) patients with resection and extended end-to-end anostomosis. 45 (45%) patients had Arcus hypoplasia. 36 (36%) of the patients underwent surgical treatment in 64 (64%) infants in the neonatal period and 2 (2%) patients in the infantile period. Of the patients, 7 (7%) had a body weight of 2.5 kg under operation, 30 (30%) of them were over 2.5-3.5 kg, 63 (63%) were over 3.5 kg. When the risk factors of recoarctation were investigated by means of available data, the patients whose body weight was below 3 kg during the operation were found to be statistically higher in terms of development of recoarthing (p = 0.001). The age, concomitant cardiac and arcus pathology were found to be a risk factor for recoarctation when the comparison was made according to the technique of operation, but when the values were not statistically significant. P values of p = 0.202, p =0.942, p = 0.328, p = 0.09, respectively. Resection and extended end-to-end anastomosis technique were found to be safer in patients with arcus hypoplasia, but statistically significant. Overall patient mortality was 13 (13%). Although the mortality rates in patients with complex cardiac pathologies were not statistically significant, the mortality rates were found to be high in this group of patients. Conclusion: Surgical treatment of aortic coarctation has acceptable mortality and recoarctation rates. Resection and extended end-to-end anostomosis technique should be preferred when there is accompanying Arcus hypoplasia in patients. Key words: Aortic coarctation; body weight; The recoarctation; arcus hypoplasia; operation technique