Echocardiographic predictors of recoarctation following surgical repair – a Swedish national study
Weismann, Constance G. LU
; Grell, Bernhard
LU
; Odermarsky, Michal
LU
; Mellander, Mats
and Liuba, Petru
LU
(2021)
In Annals of Thoracic Surgery
111(4).
p.1380-1386
- Abstract
- Background
Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms.
Methods
Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017.
Results
253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Z-scores combined with surgical and demographic factors. We defined reCoA risk categories as low (≤10%),... (More) - Background
Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms.
Methods
Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017.
Results
253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Z-scores combined with surgical and demographic factors. We defined reCoA risk categories as low (≤10%), moderate (11-29%), moderate-high (30-49%) and high (≥50%). Patients with a) isthmus ≤3.3mm (1- and 5-year event free survival 38 and 32%) or b) isthmus Z-score ≤-2.8 with a weight at surgery <4.4kg (1- and 5-year event free survival 21 and 16%) were at highest risk for reCoA. Conversely, patients at low risk had a) isthmus >3.7mm and distal aortic arch >3.5mm (1- and 5-year event free survival 97 and 97%), and b) isthmus and proximal aortic arch Z-score >-2.8 or operative weight >4.4kg with an isthmus Z-score <=-2.8 with (1- and 5-year event free survival 97 and 97%).
Conclusion
ReCoA risk can be predicted based on postoperative pre-discharge echocardiographic variables in combination with surgical and demographic factors. We suggest tailoring follow-up intervals individually according to the predicted reCoA risk. (Less) - Abstract (Swedish)
- Background: Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms.
Methods: Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017.
Results: 253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Zscores combined with surgical and demographic factors. We defined reCoA risk categories as low (<10%), moderate... (More) - Background: Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms.
Methods: Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017.
Results: 253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Zscores combined with surgical and demographic factors. We defined reCoA risk categories as low (<10%), moderate (11-29%), moderate-high (30-49%) and high (>50%). Patients with
a) isthmus >3.3mm (1- and 5-year event free survival 38 and 32%) or b) isthmus Z-score >- 2.8 with a weight at surgery <4.4kg (1- and 5-year event free survival 21 and 16%) were at
highest risk for reCoA. Conversely, patients at low risk had a) isthmus >3.7mm and distal aortic arch >3.5mm (1- and 5-year event free survival 97 and 97%), and b) isthmus and proximal aortic arch Z-score >-2.8 or operative weight >4.4kg with an isthmus Z-score <=-2.8 with (1- and 5-year event free survival 97 and 97%).
Conclusion: ReCoA risk can be predicted based on postoperative pre-discharge
echocardiographic variables in combination with surgical and demographic factors. We
suggest tailoring follow-up intervals individually according to the predicted reCoA risk. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/09acc315-8b89-4c91-85e7-7318c9e9d0e8
- author
- Weismann, Constance G.
LU
; Grell, Bernhard
LU
; Odermarsky, Michal
LU
; Mellander, Mats
and Liuba, Petru
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Thoracic Surgery
- volume
- 111
- issue
- 4
- pages
- 1380 - 1386
- publisher
- Elsevier
- external identifiers
-
- pmid:32619613
- scopus:85099653781
- ISSN
- 0003-4975
- DOI
- 10.1016/j.athoracsur.2020.05.062
- language
- English
- LU publication?
- yes
- id
- 09acc315-8b89-4c91-85e7-7318c9e9d0e8
- date added to LUP
- 2020-07-01 15:18:48
- date last changed
- 2022-08-02 13:12:11
@article{09acc315-8b89-4c91-85e7-7318c9e9d0e8,
abstract = {{Background<br>
Following surgical repair of aortic coarctation (CoA) there is a risk for restenosis (reCoA), particularly in the first year of life. It was the aim of this study to identify reCoA risk factors by analyzing postoperative pre-discharge echocardiograms.<br>
Methods<br>
Retrospective analysis of echocardiograms of children born operated for CoA in Sweden 2011-2017.<br>
Results<br>
253 children were included; median age at surgery 10 days; median follow-up 4.6 years. ReCoA occurred in 34 patients (13%; 74% by 6 months, 91% by 12 months). We generated two reCoA risk models applying a) aortic dimensions and b) the respective Z-scores combined with surgical and demographic factors. We defined reCoA risk categories as low (≤10%), moderate (11-29%), moderate-high (30-49%) and high (≥50%). Patients with a) isthmus ≤3.3mm (1- and 5-year event free survival 38 and 32%) or b) isthmus Z-score ≤-2.8 with a weight at surgery <4.4kg (1- and 5-year event free survival 21 and 16%) were at highest risk for reCoA. Conversely, patients at low risk had a) isthmus >3.7mm and distal aortic arch >3.5mm (1- and 5-year event free survival 97 and 97%), and b) isthmus and proximal aortic arch Z-score >-2.8 or operative weight >4.4kg with an isthmus Z-score <=-2.8 with (1- and 5-year event free survival 97 and 97%).<br>
Conclusion<br>
ReCoA risk can be predicted based on postoperative pre-discharge echocardiographic variables in combination with surgical and demographic factors. We suggest tailoring follow-up intervals individually according to the predicted reCoA risk.}},
author = {{Weismann, Constance G. and Grell, Bernhard and Odermarsky, Michal and Mellander, Mats and Liuba, Petru}},
issn = {{0003-4975}},
language = {{eng}},
number = {{4}},
pages = {{1380--1386}},
publisher = {{Elsevier}},
series = {{Annals of Thoracic Surgery}},
title = {{Echocardiographic predictors of recoarctation following surgical repair – a Swedish national study}},
url = {{http://dx.doi.org/10.1016/j.athoracsur.2020.05.062}},
doi = {{10.1016/j.athoracsur.2020.05.062}},
volume = {{111}},
year = {{2021}},
}