title: [Aortic coarctation. Indications and results of surgical treatment. 16 years of experience].
abstract: Eighty-nine patients were treated surgically for coarctation of the aorta in a period of 16 years. In 79, the operative procedure consisted of excision of the coarcted segment and primary anastomosis; in 7 cases of hypoplastic arch and in 3 of aneurysm of the aorta, some form of aortoplasty utilizing the isthmus and the subclavian artery, or the use of a dacron prosthesis were required. In a group of 33 patients under 2 years, 76% had associated cardiac anomalies and 100% heart failure, which made immediate surgical treatment mandatory with a mortality of 42% and a recoarctation rate of 10.5%. Out of 56 cases over 2 years, 46% had other cardiac malformations; however, a less severe clinical conditions allowed for an elective operation, with a mortality of 1.8% and a recoarctation rate of 1.8%. This experience and the review of the literature support the concept of elective surgical treatment for coarctation of the aorta around the age of 4 years, prior to the occurrence of hypertension or its complications. In the neonate and infant, surgery is justified in the presence of heart failure non-responsive to medical treatment within 24 to 48 hours. A deeper understanding of the pathophysiology of the malformation in the very young and a better perioperative management of neonates, have led to a decline in mortality in recent years.
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000601:surgery*; D008297:Male; D008800:Mexico; D011183:Postoperative Complications; D012189:Retrospective Studies
vernacular_title: Coartación de la aorta. Indicaciones y resultados del tratamiento quirúrigico. Dieciséis años de experiencia