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- W2039115220 abstract "Apart from case reports not much is known about very long-term durability of (re) construction performed in children for abdominal aortic coarctation (AAC). From 1979 to 2009 44 children (21 m, 23 f, mean age 13, SD 5, 2 y, min1/max 18y) of which 10 had been attempted before elsewhere (PTA 9, surgery 2) underwent surgery (by W. S.) for AAC (aorto-aorta bypass n = 6; autogenous n = 28, homologous n = 7 reconstruction of renal arteries in 25 p.; aorto-renal-mesenteric grafts in 12 p. -in 2 small children replacement by paternal deep femoral vein) to achieve normalization of vascular anatomy for healing and/or improvement of hypertension (HBP), renal insufficiency and claudication. After mean 114 SD 81 months 42 (95%) patients (mean age 21, 5 y) were alive (2 deaths after 7 and 12 y, unknown cause). Ten patients had undergone a second and 3 a third operation. 39 patients were re-examined by duplex and MRA in 2009, 3 without reex. because in foreign country. Hypertension early/late after surgery was cured in 27%/53%, improved in 34%/33% and remained unchanged in 39%/14%. There were no problems at the anastomotic regions after thoraco-abdominal Dacron grafts, while PTFE and homologous grafts were prone to develop stenosis at the proximal anastomosis. None of the dilated vein grafts developed an aneurysm and none of the thoraco-abdominal long length bypass grafts prevented normal growth. Reconstructive surgery for AAC in children yields good and durable results, even if performed in early childhood. The healing/improvement rate of HBP was almost 90%, which is better than results reported after PTA, but in 18% secondary/tertiary procedures became necessary. Graft-specific problems were less than expected. However these children should be followed closely into the adult age and in case of remaining/recurrent and de novo significant disease surgery should not be delayed, because HBP is the main risk factor for early cardiovascular disease in later life." @default.
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- W2039115220 date "2010-06-01" @default.
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- W2039115220 title "SS32. Long-term Results of Aorto-Arterial Surgery in Children With Renovascular Hypertension From Mid Aortic Syndrome With and Without Involvement of Renal and Mesenteric Arteries: Single-Center Experience in 44 Cases" @default.
- W2039115220 doi "https://doi.org/10.1016/j.jvs.2010.02.207" @default.
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