Surgical treatment of coarctation of the aorta with minimal collateral circulation.
Twenty-four aortic coarctation patients with minimal collaterals were operated on. Left-side bypass was used in 18 cases, internal shunt in 4, while a jump graft ws inserted in 2 cases. These methods were applied when the distal aortic pressure fell below 50 mmHg systolic during test clamping. The coarctation was corrected with isthmusplasty in 12 cases, resection and end-to-end anastomosis in 5 cases, resection with prosthetic replacement in 5 cases and jump graft in 2 cases. The operative mortality was 2 patients (8.3%). One patient died of complications of a post-perfusion bleeding tendency; the other, who had concomitant aortic insufficiency, died of cerebral infarction and pneumonia. At follow-up examination, the blood pressure difference between the upper and lower extremities had disappeared in all cases. The blood pressure was still over 150 mmHg systolic in 9 patients, 8 of whom received anti-hypertensive medication. One patient died during the follow-up period, while waiting for an operation for aortic insufficiency.
D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality