[Surgical repair of coarctation of the aorta during infancy]

Abstract

Fourty-six infants less than 1 year of age underwent repair of coarctation of the aorta in our institution between 1972 and 1991. Pathologic types and numbers of patients were simple coarctation (Group 1) in 7 patients, with ventricular septal defects (Group 2) in 22 patients and with complex cardiac anomalies (Group 3) with 17 patients. A patent ductus arteriosus was present in 43 of these patients. Operative technique used were resection and end-to-end anastomosis (RETE) in 30 patients, subclavian flap angioplasty (SFA) in 15 and Blalock-Park operation in one patient. RETE procedures were employed from 1972 until 1980 and SFA procedures were employed between 1981 and 1985. After 1986 RETE procedures were employed again. The operative mortality rates were 0% (0/7) in Group 1, 9.1% (2/22) in Group 2 and 82.3% (14/17) in Group 3. The high mortality rate in Group 3 are thought to be related to severe associated cardiac anomalies. There were no significant differences in the operative mortality and recurrent coarctation rates between RETE and SFA procedures in Group 1 and 2. In patient with a large associated intracardiac shunt (Group 2 and 3) banding of the main pulmonary artery (PAB) was performed with coarctectomy simultaneously. In Group 2 VSD closure and debanding could be done a few months later with excellent results, but in Group 3 primary repair of cardiac anomalies may be worth to try since results of coarctectomy with palliative procedures in these group of patients were poor.(ABSTRACT TRUNCATED AT 250 WORDS)