Browsing by Author "Gebremeskel, Kalkidan"

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    Clinical profile and outcome of repaired cases of Coarctation of Aorta at TASH paediatric cardiology unit Ethiopia from Jan 2009 to Feb 2017G.C
    (2017-10) Gebremeskel, Kalkidan; Moges, Tamirat(Dr.)
    Introduction Coarctation of aorta (COA) is one of the acyanotic congenital heart disease where the portion of aorta gets narrowed often involving the descending aorta distal to the aortic isthmus. It requires treatment with definitive surgery or balloon dilation and if not treated associated with many complication. But even after the advert of multiple surgical approach it is associated with post- operative complication at times may also need lifelong post op follow up. Little experience is available in Ethiopia regarding post coarctation of aorta repair. Objectives To determine clinical profile and post-repair outcome of children with COA who underwent repair for COA. Methodology: The study was conducted from March 2017 to Sept 30 of 2017 with a retrospective chart review of 39 patients with repair for native COA from Jan 2003 to Feb 2017 both at local and outside of the country. In this study clinical profile, immediate complication and outcome were assessed. Result : A total of 39 patient with repair of COA of which 27(67.3%) were male and 12(30.8%) female. The age at time of intervention ranges from 3months to 25 years, with mean age of 6.9 ±5.7 yrs. 82.1% of the patients were hypertensive before intervention. 15(38.5%) had complex COA,13(33.3%) discrete COA,7(17.9) simple COA,4(10.3%) with interrupted aorta. Type of intervention was balloon angioplasty with or without stent in 20(51.3%), end to end resection and anastomosis 14(35.9%) and patch arthroplasty in 5(12.8%). Immediate complication seen were rebound hypertension 18(46.15%), post coarctectomy syndrome 3(7.69%). Other complication include Intracranial hemorrage, spinal cord injury ,pneumomedastinium ,chylothorax, Infective endocarditis, pericardial effusion, hemodynamic collapse 2ry to bleeding , lung atelectasis complicate 1(2.56%) each. There was no death following surgery. At 6 month 35 patient were evaluated at follow up clinic and only 40% of patients where hypertensive and echocardiography shows residual COA in 7(20%) and aneurism in 1(2.85%) patient. Conclusion: the most practiced method of the repair in the study was balloon angioplasty. Rebound hypertension was the most common immediate complication encountered. Mortality rate is very low comparing it from other setting. Surgical repair has significant association with rebound hypertension. Six month follow up echocardiography showed significant number of re-coarctation