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Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era
The objective of this study was to determine the efficacy of balloon angioplasty (BA) by comparing the immediate and long-term outcomes of patients with and without re-coarctation after a Norwood procedure. Although BA has become the standard means for treating recurrent coarctation following a Norw...
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Published in: | Journal of the American College of Cardiology 2005-06, Vol.45 (11), p.1844-1848 |
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container_title | Journal of the American College of Cardiology |
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creator | Zeltser, Ilana Menteer, Jondavid Gaynor, J. William Spray, Thomas L. Clark, Bernard J. Kreutzer, Jacqueline Rome, Jonathan J. |
description | The objective of this study was to determine the efficacy of balloon angioplasty (BA) by comparing the immediate and long-term outcomes of patients with and without re-coarctation after a Norwood procedure.
Although BA has become the standard means for treating recurrent coarctation following a Norwood operation, it has been suggested that re-coarctation remains a significant cause of morbidity and mortality.
Patients who survived a Norwood operation from December 1986 through June 2001 were studied. Differences between groups were evaluated by ttest and logistic regression. Survival differences were tested by log-rank tests using Kaplan-Meier survival curves.
Fifty-eight of 633 patients underwent treatment for re-coarctation (9.2%). Thirty-five patients underwent BA (before 1988, 23 had surgery). Median age at catheterization was 6.6 months (1.9 to 35.6 months). Balloon angioplasty was successful (gradient |
doi_str_mv | 10.1016/j.jacc.2005.01.056 |
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Although BA has become the standard means for treating recurrent coarctation following a Norwood operation, it has been suggested that re-coarctation remains a significant cause of morbidity and mortality.
Patients who survived a Norwood operation from December 1986 through June 2001 were studied. Differences between groups were evaluated by ttest and logistic regression. Survival differences were tested by log-rank tests using Kaplan-Meier survival curves.
Fifty-eight of 633 patients underwent treatment for re-coarctation (9.2%). Thirty-five patients underwent BA (before 1988, 23 had surgery). Median age at catheterization was 6.6 months (1.9 to 35.6 months). Balloon angioplasty was successful (gradient <10 mm Hg) in 32 of 35 patients (92%). There were no BA-related deaths or neurologic complications. Recurrent obstruction after BA occurred in seven patients (20%); five underwent re-dilation. Kaplan-Meier estimates of freedom from recurrent obstruction after initial BA were 97% at one month, 79% at one year, and 79% at five years. There were no differences in survival between patients with re-coarctation treated by BA and patients who did not undergo treatment for re-coarctation.
We found that 9.2% of patients underwent treatment for re-coarctation following a Norwood operation. Balloon angioplasty is effective, with low morbidity, no early mortality, and no difference in long-term survival when compared with patients who did not have re-coarctation. Recurrent coarctation following BA occurred in 17% of patients, usually within the first year after BA.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.01.056</identifier><identifier>PMID: 15936617</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Angioplasty ; Angioplasty, Balloon, Coronary ; Aortic Coarctation - etiology ; Aortic Coarctation - mortality ; Aortic Coarctation - therapy ; Biological and medical sciences ; Cardiac Surgical Procedures - adverse effects ; Cardiology ; Cardiology. Vascular system ; Catheters ; Child, Preschool ; Hospitals ; Humans ; Hypoplastic Left Heart Syndrome - surgery ; Infant ; Intubation ; Medical sciences ; Mortality ; Postoperative period ; Recurrence ; Risk factors ; Studies ; Success ; Survival Analysis</subject><ispartof>Journal of the American College of Cardiology, 2005-06, Vol.45 (11), p.1844-1848</ispartof><rights>2005 American College of Cardiology Foundation</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 7, 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-ca276226f0b5f3b8c56ad2af96947f7df28020aede23e7ce6143a72c2bae0a83</citedby><cites>FETCH-LOGICAL-c558t-ca276226f0b5f3b8c56ad2af96947f7df28020aede23e7ce6143a72c2bae0a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16930565$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15936617$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeltser, Ilana</creatorcontrib><creatorcontrib>Menteer, Jondavid</creatorcontrib><creatorcontrib>Gaynor, J. William</creatorcontrib><creatorcontrib>Spray, Thomas L.</creatorcontrib><creatorcontrib>Clark, Bernard J.</creatorcontrib><creatorcontrib>Kreutzer, Jacqueline</creatorcontrib><creatorcontrib>Rome, Jonathan J.</creatorcontrib><title>Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>The objective of this study was to determine the efficacy of balloon angioplasty (BA) by comparing the immediate and long-term outcomes of patients with and without re-coarctation after a Norwood procedure.
Although BA has become the standard means for treating recurrent coarctation following a Norwood operation, it has been suggested that re-coarctation remains a significant cause of morbidity and mortality.
Patients who survived a Norwood operation from December 1986 through June 2001 were studied. Differences between groups were evaluated by ttest and logistic regression. Survival differences were tested by log-rank tests using Kaplan-Meier survival curves.
Fifty-eight of 633 patients underwent treatment for re-coarctation (9.2%). Thirty-five patients underwent BA (before 1988, 23 had surgery). Median age at catheterization was 6.6 months (1.9 to 35.6 months). Balloon angioplasty was successful (gradient <10 mm Hg) in 32 of 35 patients (92%). There were no BA-related deaths or neurologic complications. Recurrent obstruction after BA occurred in seven patients (20%); five underwent re-dilation. Kaplan-Meier estimates of freedom from recurrent obstruction after initial BA were 97% at one month, 79% at one year, and 79% at five years. There were no differences in survival between patients with re-coarctation treated by BA and patients who did not undergo treatment for re-coarctation.
We found that 9.2% of patients underwent treatment for re-coarctation following a Norwood operation. Balloon angioplasty is effective, with low morbidity, no early mortality, and no difference in long-term survival when compared with patients who did not have re-coarctation. Recurrent coarctation following BA occurred in 17% of patients, usually within the first year after BA.</description><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Aortic Coarctation - etiology</subject><subject>Aortic Coarctation - mortality</subject><subject>Aortic Coarctation - therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Catheters</subject><subject>Child, Preschool</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypoplastic Left Heart Syndrome - surgery</subject><subject>Infant</subject><subject>Intubation</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Postoperative period</subject><subject>Recurrence</subject><subject>Risk factors</subject><subject>Studies</subject><subject>Success</subject><subject>Survival Analysis</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp9kMFq3DAURUVpaKZpf6CLYijtzs6TPJJs6CYZkjQQEkizF2_k51TGY7mSPSF_X01mIJBFQSCQzr1cDmNfOBQcuDrtig6tLQSALIAXINU7tuBSVnkpa_2eLUCXMudQ62P2McYOAFTF6w_smMu6VIrrBbPXmxHtlPk2u6d85THYCSfnh-zS971_csNjNv2h7NaHJ--b7G6ksP9P5_cctm6LfeaGF-gcUyS9nw2Pzo89xuk5uwj4iR212Ef6fLhP2MPlxcPqV35zd3W9OrvJbdo85RaFVkKoFtayLdeVlQobgW2t6qVuddOKCgQgNSRK0pYUX5aohRVrJMCqPGE_9rVj8H9nipPZuGip73EgP0ejdFXXEnbgtzdg5-cwpGmGS1BcLYVUiRJ7ygYfY6DWjMFtMDwbDmbn33Rm59_s_BvgBl5CXw_V83pDzWvkIDwB3w8ARot9G3CwLr5yqi5Tj0zczz1HSdjWUTDROhosNS6QnUzj3f92_AOFlKNo</recordid><startdate>20050607</startdate><enddate>20050607</enddate><creator>Zeltser, Ilana</creator><creator>Menteer, Jondavid</creator><creator>Gaynor, J. William</creator><creator>Spray, Thomas L.</creator><creator>Clark, Bernard J.</creator><creator>Kreutzer, Jacqueline</creator><creator>Rome, Jonathan J.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20050607</creationdate><title>Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era</title><author>Zeltser, Ilana ; Menteer, Jondavid ; Gaynor, J. William ; Spray, Thomas L. ; Clark, Bernard J. ; Kreutzer, Jacqueline ; Rome, Jonathan J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-ca276226f0b5f3b8c56ad2af96947f7df28020aede23e7ce6143a72c2bae0a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Aortic Coarctation - etiology</topic><topic>Aortic Coarctation - mortality</topic><topic>Aortic Coarctation - therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Catheters</topic><topic>Child, Preschool</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypoplastic Left Heart Syndrome - surgery</topic><topic>Infant</topic><topic>Intubation</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Postoperative period</topic><topic>Recurrence</topic><topic>Risk factors</topic><topic>Studies</topic><topic>Success</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeltser, Ilana</creatorcontrib><creatorcontrib>Menteer, Jondavid</creatorcontrib><creatorcontrib>Gaynor, J. William</creatorcontrib><creatorcontrib>Spray, Thomas L.</creatorcontrib><creatorcontrib>Clark, Bernard J.</creatorcontrib><creatorcontrib>Kreutzer, Jacqueline</creatorcontrib><creatorcontrib>Rome, Jonathan J.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeltser, Ilana</au><au>Menteer, Jondavid</au><au>Gaynor, J. William</au><au>Spray, Thomas L.</au><au>Clark, Bernard J.</au><au>Kreutzer, Jacqueline</au><au>Rome, Jonathan J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2005-06-07</date><risdate>2005</risdate><volume>45</volume><issue>11</issue><spage>1844</spage><epage>1848</epage><pages>1844-1848</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>The objective of this study was to determine the efficacy of balloon angioplasty (BA) by comparing the immediate and long-term outcomes of patients with and without re-coarctation after a Norwood procedure.
Although BA has become the standard means for treating recurrent coarctation following a Norwood operation, it has been suggested that re-coarctation remains a significant cause of morbidity and mortality.
Patients who survived a Norwood operation from December 1986 through June 2001 were studied. Differences between groups were evaluated by ttest and logistic regression. Survival differences were tested by log-rank tests using Kaplan-Meier survival curves.
Fifty-eight of 633 patients underwent treatment for re-coarctation (9.2%). Thirty-five patients underwent BA (before 1988, 23 had surgery). Median age at catheterization was 6.6 months (1.9 to 35.6 months). Balloon angioplasty was successful (gradient <10 mm Hg) in 32 of 35 patients (92%). There were no BA-related deaths or neurologic complications. Recurrent obstruction after BA occurred in seven patients (20%); five underwent re-dilation. Kaplan-Meier estimates of freedom from recurrent obstruction after initial BA were 97% at one month, 79% at one year, and 79% at five years. There were no differences in survival between patients with re-coarctation treated by BA and patients who did not undergo treatment for re-coarctation.
We found that 9.2% of patients underwent treatment for re-coarctation following a Norwood operation. Balloon angioplasty is effective, with low morbidity, no early mortality, and no difference in long-term survival when compared with patients who did not have re-coarctation. Recurrent coarctation following BA occurred in 17% of patients, usually within the first year after BA.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15936617</pmid><doi>10.1016/j.jacc.2005.01.056</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Angioplasty Angioplasty, Balloon, Coronary Aortic Coarctation - etiology Aortic Coarctation - mortality Aortic Coarctation - therapy Biological and medical sciences Cardiac Surgical Procedures - adverse effects Cardiology Cardiology. Vascular system Catheters Child, Preschool Hospitals Humans Hypoplastic Left Heart Syndrome - surgery Infant Intubation Medical sciences Mortality Postoperative period Recurrence Risk factors Studies Success Survival Analysis |
title | Impact of Re-Coarctation Following the Norwood Operation on Survival in the Balloon Angioplasty Era |
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