title: Revisiting subclavian flap repair for neonates and small infants.
abstract: OBJECTIVE
  We have utilized subclavian flap angioplasty (SFA) frequently in infants with coarctation particularly in patients with arch hypoplasia which is quite frequent. We have followed these patients with serial echocardiography and have analyzed our results in this study to determine recoartation rates, recurrent hypertension and left arm development.
  
  
  METHODS
  Thirty eight infants less than 3 months age (22 boys and 16 girls, mean age was 28±22.6 days) operated at Dokuz Eylul University Hospital between August 2007 - December 2013. Twelve (32%) patients with pulmonary banding due to accompanying VSD or AVSD were included to the study, those infants with complex pathologies such as transposition of great arteries or single ventricle, while the patients less than 1000 gram in weight were excluded.
  
  
  RESULTS
  The mean follow-up time was 21 months (1-76 months). Twelve (32%) patients had aortic arch hypoplasia proximal to the left subclavian artery. Operative mortality was found 7.7% for isolated coarctation, 16% for coarctation repair with pulmonary banding. In 5 patients, a residual gradient was detected and re intervention was required in 7.8% patients with balloon angioplasty.
  
  
  CONCLUSIONS
  Subclavian flap angioplasty is a safe repair technique in small infants and neonates. High gradients and intervention more likely depends on the anatomy of the aortic arch rather than the subclavian flap angioplasty technique.
authors: Mustafa Kir, MD, Department of Pediatric Cardiology, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Mustafa
authors: M
authors: Kir
authors: Baran Ugurlu, MD, Department of Cardiovascular Surgery, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Baran
authors: B
authors: Ugurlu
authors: Nurettin Unal, MD, Department of Pediatric Cardiology, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Nurettin
authors: N
authors: Unal
authors: Kivanç Metin, MD, Department of Cardiovascular Surgery, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Kivanç
authors: K
authors: Metin
authors: Nuh Yilmaz, MD, Department of Pediatric Cardiology, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Nuh
authors: N
authors: Yilmaz
authors: Ozgur Kizilca, MD, Department of Pediatric Cardiology, Dokuz Eylul University Faculty of Medicine, Inciralti-Izmir 35340 Turkey.
authors: Ozgur
authors: O
authors: Kizilca
keywords: Aortic coarctation; Children; Subclavian flap angioplasty