Browsing by Author "Mimić, Branko (55891059600)"

Introduction Diagnosis of neonatal coarctation of the aorta (CoA) still presents a challenge in routine practice because of absence of reliable morphologic and functional parameters for early detection of this congenital heart defect in newborns. Objective The aim of this study is to identify easy obtainable two-dimensional echocardiographic parameters for detection of the CoA in newborns. Methods Echocardiographic evaluation was performed in 30 newborns with CoA and 20 healthy neonates (control group). Measurements of the proximal transverse arch (PTA), distal transverse arch (DTA), isthmus, distance between the left common carotid artery (LCCA) at the origin of the left subclavian artery (LSA), were obtained by two-dimensional echocardiography. Aortic arch hypoplasia was defined using Mouleart, Karl and Mee criteria, and Z-value. Index 1 was calculated as a ratio of DTA and distance between origins LCCA-LSA, Index 2 was calculated as a ratio of the ascending aorta and the distance between LCCA-LSA origins, and Index 3 was calculated as a ratio of PTA and distance between LCCA-LSA origins. Results Index 1 was significantly lower in patients with CoA in comparison with control group (0.50 vs. 1.39; p≤0.01). A cutoff point at 0.39, for Index 1, showed a sensitivity of 92% and specificity of 99% for the diagnosis of neonatal CoA, while cut off points at 0.69 and 0.44, for Index 2 and Index 3, showed the highest sensitivity and specificity for the diagnosis of CoA in newborns. Conclusion By using these echo indexes, two-dimensional echocardiographic aortic arch measurement becomes a simple, reliable noninvasive method for the evaluation of aortic coarctation in newborns and may lead to earlier diagnosis and subsequent surgical correction. © 2015 Serbia Medical Society. All rightsreserved.

Introduction Combination of acute aortic dissection associated with aortic coarctation in pediatric population is extremely rare. We are presenting a 12-year-old patient with these two conditions who was successfully treated with two-stage surgery. Case Outline A boy with no trauma history was admitted for chest pain. The diagnosis of acute aortic dissection associated with aortic coarctation was established with echocardiography and computed tomography angiography. Emergent surgery was performed-excision of the ascending aorta aneurysm with supracoronary graft replacement and preservation of native aortic valve. Subsequently, through posterolateral left thoracotomy, the patient underwent end-to-end aortoplasty for coarctation repair. Conclusion Two-stage surgery provides favorable outcome in this rare, life threatening condition in the pediatric age group. Native aortic valve was preserved and extra-anatomic bypass of aortic coarctation was avoided. Further monitoring of aortic valve is mandatory. © 2017, Serbia Medical Society. All rights reserved.