LONG-TERM RESULTS SURGICAL TREATMENT OF NEWBORNS WITH CRITICAL AORTIC COARCTATION

In the period from 2004 to 2016 in the department of cardiovascular surgery Odessa Regional Pediatric Hospital 70 patients were operated with critical CoA: 21 (31.5%) infants with isolated CoA, 16 (22.8%) patients CoA combined with interventricular septum defect (VSD), 31 patients (45.7%) — CoA combined with distal aortic arch hypoplasia (DАA) and other intracardiac abnormality. Z-score is the significant criterion in detection of hypoplastic aortic arch segments. In patients with DAAH median preoperative diameter of aortic arch segments were “А” — (2.50±0.33) mm (Z-score — 4.04);  “В” — (3.73±0.38) mm (Z-score — 3.54); “С” — (7.2±0.6) mm (Z-score 0.03). All operations were performed through the left posterior thoracotomy at fourth intercostal space. Twenty two (31.5%) newborns with CoA underwent resection and extended end-to-end anastomosis between descending aortic and aortic arch. Thirty (42.8%) newborns had CoA, DAAH and septal defects. Ten of theme had PA banding, at first they had modified Amato distal aortic arch plasty. In 2 years after operation revealed significant growth of the aortic arch of 45 patiets. Median sizes of aortic arch segments were “А” — (9.80±0.54) mm (Z-score 0.45); “В” — (9.20±0.34) mm (Z-score 0.53); “С” — (10.1±0.4) mm  (Z-score 0.35). The total period of observation for patients was more than 10 years. 68 (97.2%) patients underwent surgery well. Lethality was 2.8%.