Role of extended aortoplasty related to the definition of coarctation of the aorta.
One hundred thirty-nine patients underwent operation for coarctation of the aorta. Age ranged from 1 day to 21 years and weight, from 1.5 to 70.4 kg. Numerous methods of repair were used. The operative mortality was low (1.3%), and 17 patients (11.3%) died late. Recoarctation occurred in 13 patients (9.4%). We attempted to correlate mortality and recoarctation with the surgical procedure. A review of the literature revealed no classifications of coarctation that applied to the anatomical and pathological variations we found at the time of operation. Therefore, we devised a surgical classification to separate the various entities in the spectrum of coarctation: type I = primary coarctation; type II = coarctation with isthmus hypoplasia; and type III = coarctation with tubular hypoplasia involving the isthmus and segment between the left carotid and left subclavian arteries. Each of these types has subtypes: A = with ventricular septal defect and B = with other major cardiac defects. We believe that rather than labeling one procedure as "the procedure of choice," providing this classification will allow the surgeon to use a method of repair that is suited to the anatomical variation.
Amato
J J
JJ
Pediatric Cardiothoracic Surgery, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Galdieri
R J
RJ
Cotroneo
J V
JV
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000601:surgery*; D001017:Aortic Coarctation / Q000145:classification / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D014656:Vascular Surgical Procedures / Q000379:methods