title: Coarctation of the aorta in neonates and young infants: surgical experience.
abstract: A retrospective analysis of repair of aortic coarctation in young infants was conducted. Between April 1997 and December 2000, 21 patients under 4 months of age underwent repair of coarctation. Their mean age and weight were 41   42 days (range, 2 to 120 days) and 3.6   0.7 kg (range, 2.6 to 4.9 kg). The indications for surgery were congestive heart failure and/or shock. Diagnosis was made by 2-dimensional echocardiography with Doppler color flow imaging. Preoperative gradients ranged from 25 to 100 mm Hg. Aortic arch hypoplasia was present in 8 patients; 7 patients also had ventricular septal defect. Wide excision of the coarctation segment with extended end-to-end anastomosis was performed in 20 patients, while 1 required a Gore-Tex interposition graft between the left common carotid artery and the descending aorta. Subclavian angioplasty was performed to augment the anastomosis in 1 patient. There was no early mortality. One patient died 2 months after surgery. Follow-up examination revealed recoarctation in 5 patients (23.8%), all of whom underwent successful balloon dilatation. In conclusion, wider excision of the coarctation with extended end-to-end anastomosis reduces the chances of recoarctation. Percutaneous balloon angioplasty for treating recoarctation is effective in immediately reducing pressure gradients.
authors.affiliation: Department of Cardiac Surgery, Al Mafraq Hospital, Abu Dhabi, United Arab Emirates.
authors.forename: Pantula
authors.initials: P
authors.lastname: Narasinga Rao
authors.forename: Raghavan Nair Suresh
authors.initials: RN
authors.lastname: Kumar
authors.forename: Dharmapuram
authors.initials: D
authors.lastname: Anil Kumar
authors.forename: Hassan Mohamed
authors.initials: HM
authors.lastname: Mohmoud
authors.forename: Sushil
authors.initials: S
authors.lastname: Chandran
authors.forename: Achal Kumar
authors.initials: AK
authors.lastname: Dhir
authors.forename: Dileep Kumar
authors.initials: DK
authors.lastname: Saxena
authors.forename: Sivan Pillay
authors.initials: SP
authors.lastname: Azhagappan
authors.forename: Velayudhan Ramakrishna
authors.initials: VR
authors.lastname: Pillai
authors.forename: Chokkanathapuram Gopalakrishnan
authors.initials: CG
authors.lastname: Venkitachalam
authors.forename: Mohamed Amin
authors.initials: MA
authors.lastname: Fikree
authors.forename: Yousuph Abdul
authors.initials: YA
authors.lastname: Nazer
authors.forename: Timothy Boyd
authors.initials: TB
authors.lastname: Cartmill
authors.forename: Ivatury
authors.initials: I
authors.lastname: Mrutyunjaya Rao
mesh_terms: D000367:Age Factors; D000714:Anastomosis, Surgical; D017130:Angioplasty; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D019917:Blood Vessel Prosthesis Implantation; D001835:Body Weight; D018618:Echocardiography, Doppler, Color; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies