Liječnički vjesnik, Vol. 137 No. 1-2, 2015.
Original scientific paper
COARCTATION OF THE AORTA IN CHILDREN IN THE 10-YEAR EPIDEMIOLOGICAL STUDY: DIAGNOSTIC AND THERAPEUTIC CONSIDERATION
Ivan Malčić
Hrvoje Kniewald
Ana Jelić
Dalibor Šarić
Dorotea Bartoniček
Daniel Dilber
Dražen Belina
Darko Anić
Abstract
Our study is a clinical epidemiological retrospective analysis of coarctation of the aorta in a 10-year follow-up (2001–2011). The study includes 201 children, 72 (35.82%) girls and 129 (64.18%) boys (1:1,6), with an average age of 28.57±49.37 mo (0.1 – 204 mo). They are categorized in 4 age groups: <1 month, 1 month – 1 year, 1 year – 6 years, >6 years. Isolated coarctation of the aorta was found in 125 (62.19%) patients; 33 (16.42%) preductal and 92 (45.77%) postductal. Coarctation of the aorta with an additional heart defect was found in 76 (37.81%) patients; 32 (15.32%) with ventricular septal defect, 28 (13.93%) within a complex heart defect, 11 (5.47%) within the Shone syndrome, and 5 (2.49%) with a dilated cardiomyopathy. Tiredness, intense tachypneic and dyspneic difficulties are dominant features in lower age groups (newborns and infants), while claudications, headaches and epistaxis are typical in older children. In the case of as many as 61 (30.35%) patients diagnosis was missed on the previous cardiological examination. In 20 (9.95%) patients coarctation is found within the known syndromes (Turner, Noonan, Williams Beuren, Ellis van Creveld, Down, partial trisomy 18, fetal valproate syndrome). Echocardiography was performed in all patients, and in 45 (22.38%) it was the only diagnostic procedure. Altogether, 123 heart catheterizations, 38 multislice computed tomography and 15 magnetic resonance imagings were performed. The gradient on the place of coarctation before surgery or emergency procedures measured by catheter in 132 (65.67%) patients was 57.99±18.68 mmHg (20–100 mmHg). In 82 (40.80%) patients a bicuspid aortic valve was found. Average age at the time of surgery was 27.92±47.98 months (0.1–204 mo.). In 169 (84.07%) patients a cardiosurgical intervention was performed; 109 (54.23%) T-T anastomoses, 30 (14.29%) therapeutic catheterisations (balloon dilatation or stent implantation). Fatal outcome occurred in 4 (1.99%) children, all newborns or infants.
Keywords
Aortic coarctation – epidemiology, diagnosis, therapy; Heart defects, congenital – epidemiology, dagnosis, therapy; Cardiac surgical procedures – methods, adverse effects; Stents; angioplasty, balloon; Croatia – epidemiology
Hrčak ID:
172666
URI
Publication date:
26.2.2015.
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