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Histopathological evaluation of aortic coarctation after conventional balloon angioplasty in neonates

Published online by Cambridge University Press:  18 January 2018

Atakan Atalay ,
Aysenur Pac ,
Tugba Avci ,
Neslihan İnci Zengin ,
Nadide Demir Amac ,
Deniz Eris ,
Irfan Tasoglu  and
Mustafa Pac
Atakan Atalay*
Affiliation:
Department of Cardiovascular Surgery, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Aysenur Pac
Affiliation:
Department of Pediatric Cardiology, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Tugba Avci
Affiliation:
Department of Cardiovascular Surgery, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Neslihan İnci Zengin
Affiliation:
Department of Pathology, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Nadide Demir Amac
Affiliation:
Department of Cardiovascular Surgery, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Deniz Eris
Affiliation:
Department of Pediatric Cardiology, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Irfan Tasoglu
Affiliation:
Department of Cardiovascular Surgery, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
Mustafa Pac
Affiliation:
Department of Cardiovascular Surgery, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
*
Author for correspondence: Dr A. Atalay, Turkiye Yuksek Ihtisas Hospital, Ankara 06460, Turkey. Tel: +90 5053593390; Fax: +90 312 3061469; E-mail: [email protected]
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Abstract

Background

Optimal management strategy for native aortic coarctation in neonates and young infants is still a matter of debate. The surgical procedure, histopathologic research, and clinical outcome in 15 neonates who underwent surgery after successful balloon angioplasty is the basis of this study.

Method

Between 01 October, 2014 and 01 August, 2017, we enrolled 15 patients with native aortic coarctation for this study. These patients had complications regarding recoarctation, following balloon angioplasty intervention at our institute and other centres. Surgically extracted parts were examined histopathologically and patient’s data were collected retrospectively.

Result

The reasons for recurrence of recoarctation after balloon angioplasty are as follows: patients with higher preoperative echocardiographic gradients had recoarctation earlier, neointimal proliferation, aortic intimal fibrosis at the region of ductal insertion, and ductal residual tissue debris after balloon angioplasty. No repeat intervention was required in the 15 patients who underwent surgery followed by balloon angioplasty. Early mortality was seen in one patient after surgery. Postoperative complication in the surgical group occurred in the form of chylothorax in one patient.

Conclusion

In centres in which the neonatal ICU is inexperienced, balloon angioplasty is particularly recommended. In developing neonatal clinics, balloon angioplasty, when performed on patients at their earliest possible age, delays actual corrective operation to a later date, which in turn provides less risky surgical outcomes in infants who are gaining weight, growing, and do not have any haemodynamic complaints.

Keywords

Coarctationneonatalhistopathology
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 5 , May 2018 , pp. 683 - 687
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Copyright
© Cambridge University Press 2018 

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