Late results of patch repair of coarctation of the aorta in adults using autogenous arterial wall.
BACKGROUND
Interposition grafting or patch repair of adult coarctations of the aorta are the standard methods of surgical treatment. Both involve use of prosthetic material, and patch repair using prosthetic material may lead to aneurysm formation in the long term.


METHODS
Four patients aged 17 to 29 years had been investigated for systemic hypertension and had coarctation of the aorta diagnosed on cardiac catheterization. Between March and November 1984, all 4 underwent a corrective operation. The lesions were widely incised and a broad patch of ipsilateral mammary or Abbott's artery was fashioned across the narrowing. The arteries had been enlarged in diameter because of prolonged exposure to high blood pressure as collateral vessels, although none was intrinsically diseased.


RESULTS
After 12 years of follow-up, only 1 patient remains on antihypertensive therapy. Spiral computed tomographic reconstructions revealed only very mild residual stenosis in 1 patient, confirmed by subsequent aortography.


CONCLUSIONS
In adult patients with coarctation of the aorta, the use of the enlarged internal mammary artery as a patch graft is a simple, quick procedure, which may give lasting relief of obstruction. Spiral computed tomographic scanning is an ideal noninvasive method of follow-up.
Owens
W A
WA
Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, Northern Ireland.
Tolan
M J
MJ
Cleland
J
J
D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000601:surgery*; D001027:Aortography; D001158:Arteries / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008323:Mammary Arteries / Q000637:transplantation*