Surgical experience of coarctation of the aorta in infants and young children.
We evaluated the effectiveness of surgical treatment for coarctation of the aorta in infants and young children, based on our experience over 7 years. From March 1999 to December 2005, 168 cases of coarctation of the aorta in patients aged 21 days to 3 years were treated by end-to-end, extended end-to-end, or extended end-to-side ascending aorta and aortic arch anastomosis. The mortality rate was 0.6%. In 138 (82%) patients, the pressure in the lower extremity was higher than in the upper extremity. During 6-24 months of follow-up, hoarseness appeared in 6 patients. Echocardiography revealed stenosis of the end-to-end anastomosis in only 2 patients. We suggest that the best option for surgical treatment of coarctation of the aorta with associated cardiac malformations is a one-stage procedure using a median sternotomy approach. It is better to perform extended end-to-end anastomosis or anastomosis between the distal descending aorta and the left wall of the ascending aorta, or to extend this anastomosis to the transverse arch.
Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Xin Hua Hospital and Shanghai Second Medical University, Shanghai 200127, China. haohao6554@hotmail.com
Jing-Hao
JH
Zheng
Jin-Fen
JF
Liu
Zhi-Wei
ZW
Xu
Zhao-Kang
ZK
Su
Wen-Xiang
WX
Ding
D000714:Anastomosis, Surgical; D001017:Aortic Coarctation / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005500:Follow-Up Studies; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects