[Evaluation of surgical treatment results of coarctation of the aorta in neonates and young infants].
The authors present the analysis of surgical results obtained for coarctation of the aorta (CoA) in children less than 1 year of age. The material consisted of 103 infants (62 Males and 41 Females) aged 0.33-10.5 months (x = 3.3 +/- 2.6 months) treated between January 1, 1985 and December 31, 1999. All the patients were subjected to a detailed physical examination, ECG, chest X-ray and comprehensive echocardiography, while 12 children had additional hemodynamic studies and angiocardiography. Two groups were distinguished among the investigated children: Below 3 months of life (Group 1, N = 65) and above 3 months of life (Group 2, N = 38). In 69 infants, (including 55 from Group 1 and 14 from Group 2), the recommendation for surgery was circulatory failure, while in 34 infants (10 from Group 1 and 24 from Group 2), the recommendation for surgery considerable systemic hypertension with absent femoral pulses. In 76 patients, the Waldhausen procedure was performed, while 24 were subjected to aortic isthmus angioplasty using a Gore-Tex patch and 3 were subjected to end-to-end anastomosis. Six patients died, including 5 from Group 1 and 1 from Group 2. The remaining 97 infants (60 from Group 1 and 37 from Group 2) were followed-up for a mean period of 96.2 +/- 48.2 months. Postoperative recoarctation was encountered in 12 patients (12.4%); the condition was more predominant in Group 1 (16.6%) than in Group 2 (5.4%), but, no statistical significance was noted (Chi 2 = 2.677, p = 0.102). Despite the repair of aortic coarctation, systemic hypertension was noted in 17 children (17.5%) and it was equally common in both groups, but, twice as frequent in children with recoarctation.


CONCLUSIONS
1. CoAo correction in children below 3 months of age is associated with an increased risk of recoarctation. 2. Even when surgical treatment of CoAo is attempted very early in life, the risk of elevated systemic blood pressure is not completely eliminated.
Paruch
Krystyna
K
Klinika Kardiologii Dzieciecej PA Instytutu Pediatrii 30-663 Kraków, ul. Wielicka 265.
Weryński
Piotr
P
Szydłowski
Lesław
L
Rudziński
Andrzej
A
Malec
Edward
E
D000367:Age Factors; D000714:Anastomosis, Surgical; D001011:Aorta / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D013524:Surgical Flaps; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome