[Surgical treatment of coarctation of the aorta].
Repair of coarctation of the aorta was performed in 37 cases (31 patients, 6 patients of reoperation) ranging from 4 days old to 15 years old. Subclavian flap repair were performed in 15, resection and end-to-end anastomosis in 14, patch aortoplasty in 6, and interposition graft in 2. Subclavian flap angioplasty or end-to-end anastomosis is considered the procedure of choice in infants. However, the incidence of reoperation significantly increased in patients younger than age one month at initial subclavian flap repair. Mechanism of recurrent coarctation may be possibly related to retention of abnormal tissue, which is possibly ductal and/or intimal shelf, with the potential for proliferation and luminal narrowing. We suggest that in applicable case end-to-end anastomosis rather than subclavian flap angioplasty may be the surgical technique of choice in infants less than one month of age, and the most common reoperation technique was patch aortoplasty in re-stenosed cases.
Mizuno
A
A
Department of Cardiovascular Surgery, Saitama Children's Medical Center.
Nakamura
Y
Y
Takayasu
H
H
Saitoh
H
H
Matsui
M
M
D000293:Adolescent; D000367:Age Factors; D000714:Anastomosis, Surgical; D001011:Aorta / Q000601:surgery; D001017:Aortic Coarctation / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012086:Reoperation; D013348:Subclavian Artery / Q000601:surgery; D013524:Surgical Flaps