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Influence of Bovine Arch Anatomy on Surgical Outcomes of Coarctation of the Aorta

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Abstract

This study aimed to evaluate the outcome of coarctation of the aorta (CoA) repair with a special interest in bovine arch anatomy. Fifty-six patients who underwent CoA repair between 2010 and 2021 were included in this retrospective study. Of these, 11 patients had bovine arch anatomy. Surgical outcomes were reviewed. Computed tomography was used to analyze aortic arch geometry for all cases preoperatively. The gap between anastomotic sites was calculated at the linear region of the lesser curvature of the aortic arch between the distal ascending aorta and the proximal descending aorta. CoA repair was performed at a median age of 39 days (median body weight 3.3 kg). Thirty-two patients underwent extended direct anastomosis, 22 patients underwent direct anastomosis, and two patients underwent lesser curvature patch augmentation. The median follow-up period was 47 months. There were no early deaths. In patients who underwent direct and extended direct anastomosis, nine recoarctation and one left pulmonary venous obstruction events occurred. Moreover, freedom from these adverse events was 81% in normal arch and 50% in bovine arch patients at 10 years (P = 0.04). Two patients with a bovine arch anatomy who underwent lesser curvature patch augmentation had good outcomes. The distal arch was narrower and longer, and the gap between anastomotic sites was longer in patients with a bovine arch anatomy than with a normal arch (P < 0.01). In CoA with a bovine arch anatomy, the gap between anastomotic sites was long. This adversely influenced the outcomes of the CoA repairs.

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Acknowledgements

We thank Editage (www.editage.jp) for English language editing.

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The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Osaka Women’s and Children’s Hospital, 840 Murodocho, Izumi, Osaka, 594-1101, Japan

    Koji Miwa, Shigemitsu Iwai, Sanae Tsumura, Tomomitsu Kanaya, Yuji Tominaga, Shota Kawai & Yuta Teguri

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  1. Koji Miwa
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  2. Shigemitsu Iwai
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  3. Sanae Tsumura
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  4. Tomomitsu Kanaya
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  5. Yuji Tominaga
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  6. Shota Kawai
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  7. Yuta Teguri
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Contributions

Conceptualization: KM; Concept: SI; Methodology: ST; Revision and editing: TK, YT, SK, YT.

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Correspondence to Koji Miwa.

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The authors have no conflict of interest to declare that are relevant to the content of this article.

Ethical Approval

Approval was obtained from the Ethics Committee and Institutional Review Board Committee of Osaka Women’s and Children’s Hospital (Ethics Approval No. 1536; approval date: April 12th, 2022).

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The requirement for written informed consent was waived because of the retrospective design of the study.

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Miwa, K., Iwai, S., Tsumura, S. et al. Influence of Bovine Arch Anatomy on Surgical Outcomes of Coarctation of the Aorta. Pediatr Cardiol 44, 933–939 (2023). https://doi.org/10.1007/s00246-022-03072-y

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