Objectives To evaluate the outcomes of reintervention for postrepair recoarctation in young children.

Methods Between January 2011 and December 2020, all consecutive patients aged ≤3 years who were treated for postrepair recoarctation were included. Recoarctations were classified into two morphological types by three-dimensional imaging. Two methods, namely, surgical repair and balloon angioplasty (BA), were used to treat recoarctation.

Results This study included 50 patients with a median age of 10.5 months (range, 2.0–36.0 months) and a mean weight of 9.3 ± 3.1 kg. Hypoplastic recoarctation occurred most frequently in patients who had undergone patch aortoplasty at initial repair (p = 0.001). No hospital mortality occurred, and all patients achieved an increased diameter (p < 0.001) and a decreased pressure gradient (p < 0.001) at the recoarctation site immediately after reintervention. The median follow-up time after reintervention was 3.5 years (range, 16.0 days–9.6 years). Late mortality occurred in four patients (8.0%): two in the surgical group and two in the BA group (chi-square test= 0.414, p = 0.520). There was no difference in arch reobstruction after reintervention between the surgical and BA groups (chi-square test = 1.383, p = 0.240). Recoarctation with a hypoplastic morphology was the leading risk factor for arch reobstruction after reintervention (hazard ratio, 6.552; 95% confidence interval, 2.045–20.992; p = 0.002).

Conclusion Reintervention for recoarctation has favorable early outcomes in young children. However, late mortality is not rare, and arch reobstruction is common during close follow-up. For young children, recoarctation with hypoplastic morphology is the leading risk factor for reobstruction, while the choice of reintervention method exerts little effect on the outcomes of arch reintervention.

目的 评估再干预对幼儿修复后再缩窄的结果。

方法 2011 年 1 月至 2020 年 12 月，纳入所有连续接受修复后再缩窄治疗的年龄≤3 岁的患者。通过三维成像将再缩窄分为两种形态类型。两种方法，即手术修复和球囊血管成形术（BA），用于治疗再缩窄。

结果 本研究包括 50 名患者，中位年龄为 10.5 个月（范围为 2.0-36.0 个月），平均体重为 9.3 ± 3.1 kg。在初次修复时接受了补片主动脉成形术的患者最常发生发育不全的再缩窄（p  = 0.001）。没有发生住院死亡率，所有患者 在再次介入后立即在再缩窄部位实现了直径增加（ p  < 0.001）和压力梯度降低（p < 0.001）。再次干预后的中位随访时间为 3.5 年（范围为 16.0 天至 9.6 年）。4 名患者（8.0%）发生晚期死亡率：手术组 2 名，BA 组 2 名（卡方检验 = 0.414，p = 0.520）。手术组和 BA 组再介入后的足弓再阻塞无差异（卡方检验 = 1.383，p  = 0.240）。具有发育不全形态的再缩窄是再介入后足弓再阻塞的主要危险因素（风险比，6.552；95% 置信区间，2.045-20.992；p  = 0.002）。

结论 再缩窄再干预对幼儿有良好的早期疗效。然而，晚期死亡率并不罕见，并且在密切随访期间，弓形再阻塞很常见。对于幼儿来说，形态发育不全的再缩窄是再梗阻的主要危险因素，而再介入方法的选择对足弓再介入的结果影响不大。