[The results of the surgical treatment of aortic coarctation in nursing infants with a sharp decrease in left...

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Echocardiography

Background:

• Coarctation of the aorta (CA) significantly impacts left ventricular (LV) function, often presenting with reduced ejection fraction (EF) in infants.
• LV fibroelastosis is an infrequent comorbidity in pediatric CA patients.

Purpose of the Study:

• To evaluate the impact of CA correction on LV ejection fraction (EF) and volume in infants.
• To determine the optimal timing for CA surgical repair to improve long-term LV function.

Main Methods:

• Two-dimensional echocardiography was performed on 24 infants (14 days to 12 months) with CA and LV EF < 30%.
• LV end-systolic volume and EF were assessed pre- and post-correction.
• Patient outcomes were analyzed based on surgical timing (within vs. after 3 months of life).

Main Results:

• Following CA correction, LV end-systolic volume decreased by 20% and EF increased 1.5-fold within 7 days, attributed to afterload reduction.
• Long-term LV pumping function improved due to restored myocardial contractility.
• Infants operated on within 3 months showed significantly better EF (68 +/- 3.8%) compared to those operated on later (50.8 +/- 2.5%).

Conclusions:

• Surgical correction of CA rapidly improves LV systolic function by reducing afterload.
• Early surgical intervention (within 3 months) in infants with CA leads to more favorable long-term LV functional recovery.
• Compensatory hypertrophy and myocardial contractility are key factors in LV pumping function post-CA repair.