The assessment of aortic coarctation among the childrens population in Lviv region

Aim. To determine the rate of aortic coarctation, the correlation of its anatomical forms - critical and not critical, and the frequency of combination with the associated pathology; to define the features of the clinical course of its different anatomical forms; and to analyze the remote results of...

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Autores principales:	A.А. Malska, O.B. Kuryliak
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2020
Materias:	aortic coarctation associated pathology excessive arterial hypertension recoarctation Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b1671b83bef74c229671973b5df67dc6
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spelling	oai:doaj.org-article:b1671b83bef74c229671973b5df67dc62021-11-10T19:49:51ZThe assessment of aortic coarctation among the childrens population in Lviv region1029-42442415-330310.25040/aml2020.04.004https://doaj.org/article/b1671b83bef74c229671973b5df67dc62020-12-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/1https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303Aim. To determine the rate of aortic coarctation, the correlation of its anatomical forms - critical and not critical, and the frequency of combination with the associated pathology; to define the features of the clinical course of its different anatomical forms; and to analyze the remote results of the surgical correction of this defect. Material and Methods. The article represents the statistical analysis of outpatient medical records and case histories of 86 children with aortic coarctation in Lviv region. In the course of the research, retrospective and epidemiological studies were carried out; clinical (data acquisition of medical history, physical examination), instrumental (Doppler echocardiography, ECG, X-ray imaging of organs of the thoracic cavity), and statistical methods were used. Results and Discussion. It was determined that over the period of 2008-2020 years, out of 74 neonates with CoA registered at Lviv Regional Children's Hospital (Health Care of Mother and Child) 40,54% had the critical CoA form, while 59 (46%) - uncritical CoA form. In children with the critical CoA form, the most frequent findings were hypoplasia of the aortic arch (56,67%), open aortic duct (53,33%), and open oval window (53,33%); in 36,6% cases CoA was combined with the bicuspid aortic valve, interatrial septal defect, and transposition of great vessels. However, the uncritical CoA form was more frequently combined with the bicuspid aortic valve (52,27%), and hypoplastic aortic arch (31,82%); aortic stenosis was revealed in 20,45% of children. After the surgical correction in 43,59% of the operated patients with uncritical CoA, excessive arterial hypertension was observed, while in critical form, the frequency of excessive arterial hypertension among the operated patients amounted to 10%. According to our research, after the plasty of the critical CoA, aortic recoarctation was observed in 3.33% of the operated patients, whereas, in case of the uncritical CoA form, it occurred in 30,77% of the operated ones. Conclusions. Coarctation of the aorta is a congenital heart disease with relatively high incidence, amounting to 5-8% out of all congenital defects of the heart. In newborns, it is manifested by acute cardiac failure, while in elder children it is presented with arterial hypertension. Echocardiographic examination after Doppler analysis is the basic procedure of diagnostics and allows for precise determination of the CoA anatomy. The majority of cardiologists recommend prompt surgical intervention after the diagnosis has been made, and, particularly, in patients with hypertension. At present, the available surgical methods include surgical excision of the aortic obstruction, and catheter intervention (the balloon angioplasty and stent implantation) . After the surgical correction has been performed, arterial hypertension persists. The duration of hypertension after the coarctation correction depends on its duration before the diagnosis is made and the timing of surgical correction of the defect. With the child's growth, recoarctation may occur. In such patients, normal arterial pressure can be determined in the state of rest, but it may increase in the upper extremities during physical exertion.A.А. MalskaO.B. KuryliakDanylo Halytsky Lviv National Medical Universityarticleaortic coarctationassociated pathologyexcessive arterial hypertensionrecoarctationMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 26, Iss 4, Pp 4-12 (2020)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	aortic coarctation associated pathology excessive arterial hypertension recoarctation Medicine (General) R5-920
spellingShingle	aortic coarctation associated pathology excessive arterial hypertension recoarctation Medicine (General) R5-920 A.А. Malska O.B. Kuryliak The assessment of aortic coarctation among the childrens population in Lviv region
description	Aim. To determine the rate of aortic coarctation, the correlation of its anatomical forms - critical and not critical, and the frequency of combination with the associated pathology; to define the features of the clinical course of its different anatomical forms; and to analyze the remote results of the surgical correction of this defect. Material and Methods. The article represents the statistical analysis of outpatient medical records and case histories of 86 children with aortic coarctation in Lviv region. In the course of the research, retrospective and epidemiological studies were carried out; clinical (data acquisition of medical history, physical examination), instrumental (Doppler echocardiography, ECG, X-ray imaging of organs of the thoracic cavity), and statistical methods were used. Results and Discussion. It was determined that over the period of 2008-2020 years, out of 74 neonates with CoA registered at Lviv Regional Children's Hospital (Health Care of Mother and Child) 40,54% had the critical CoA form, while 59 (46%) - uncritical CoA form. In children with the critical CoA form, the most frequent findings were hypoplasia of the aortic arch (56,67%), open aortic duct (53,33%), and open oval window (53,33%); in 36,6% cases CoA was combined with the bicuspid aortic valve, interatrial septal defect, and transposition of great vessels. However, the uncritical CoA form was more frequently combined with the bicuspid aortic valve (52,27%), and hypoplastic aortic arch (31,82%); aortic stenosis was revealed in 20,45% of children. After the surgical correction in 43,59% of the operated patients with uncritical CoA, excessive arterial hypertension was observed, while in critical form, the frequency of excessive arterial hypertension among the operated patients amounted to 10%. According to our research, after the plasty of the critical CoA, aortic recoarctation was observed in 3.33% of the operated patients, whereas, in case of the uncritical CoA form, it occurred in 30,77% of the operated ones. Conclusions. Coarctation of the aorta is a congenital heart disease with relatively high incidence, amounting to 5-8% out of all congenital defects of the heart. In newborns, it is manifested by acute cardiac failure, while in elder children it is presented with arterial hypertension. Echocardiographic examination after Doppler analysis is the basic procedure of diagnostics and allows for precise determination of the CoA anatomy. The majority of cardiologists recommend prompt surgical intervention after the diagnosis has been made, and, particularly, in patients with hypertension. At present, the available surgical methods include surgical excision of the aortic obstruction, and catheter intervention (the balloon angioplasty and stent implantation) . After the surgical correction has been performed, arterial hypertension persists. The duration of hypertension after the coarctation correction depends on its duration before the diagnosis is made and the timing of surgical correction of the defect. With the child's growth, recoarctation may occur. In such patients, normal arterial pressure can be determined in the state of rest, but it may increase in the upper extremities during physical exertion.
format	article
author	A.А. Malska O.B. Kuryliak
author_facet	A.А. Malska O.B. Kuryliak
author_sort	A.А. Malska
title	The assessment of aortic coarctation among the childrens population in Lviv region
title_short	The assessment of aortic coarctation among the childrens population in Lviv region
title_full	The assessment of aortic coarctation among the childrens population in Lviv region
title_fullStr	The assessment of aortic coarctation among the childrens population in Lviv region
title_full_unstemmed	The assessment of aortic coarctation among the childrens population in Lviv region
title_sort	assessment of aortic coarctation among the childrens population in lviv region
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2020
url	https://doaj.org/article/b1671b83bef74c229671973b5df67dc6
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The assessment of aortic coarctation among the childrens population in Lviv region

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