[Surgical management of coarctation of the aorta in early infants].
Thirteen infants under three months old were repaired aortic coarctation between 1980 and 1988. The mean age at operation was 2 +/- 0.8 months, the mean weight was 3.7 +/- 0.6 kg. Patients were simple coarctation in 1, coarctation with VSD in 7, and coarctation with complex heart disease in 5. As the operative method, the prosthetic patch plasty was done in 11 patients, end to end anastomosis in 1 patient and remaining one was primary VSD closure and secondary coarctation repair (patch plasty). Three patients died perioperatively, the overall early mortality rate was 23%. Since the introduction of PGE1 therapy in 1985, operative mortality rate of the operation (patch aortoplasty) was improved dramatically. Two of 10 patients died from LOS after the secondary operation (one was TGA and another was congenital MS with VSD). Eight patients are alive and clinical course after operation had been good. The measurement of arm-leg pressure difference didn't reveal significant residual gradient. Postoperative isthmus index was 90 +/- 13% in follow up measurement. Recoarctation has not been occurred in patients undergoing operations with patch plasty. Postoperative hypoplastic arch index was 93 +/- 19% in 1 to 2 years after operation compared with 70 +/- 16% of the preoperation. Therefore, it is concluded that prosthetic patch aortoplasty and end to end anastomosis of the aorta are both available as reasonable and/or adequate operation for the early infants with coarctation.
Hamada
Y
Y
Niitu
K
K
Kimura
H
H
Komoda
K
K
Shiina
Y
Y
Chiba
S
S
Itoh
I
I
D001011:Aorta / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016896:Treatment Outcome