[Surgical treatment of critical aorta coarctation in neonates]

Coarctation of the aorta is relatively common defect accounting for 5-8% of all congenital heart defects. Newborns very often, about in 50% of cases, are in cardiogenic shock. From 1991 to 2003, 26 neonates with coarctation of the aorta underwent surgical repair at Heart Surgery Center of Vilnius University: 12 with isolated coarctation of the aorta and 14 with leading heart pathology. Age of patients was from 2 to 30 days. Weight was from 2.8 to 4.7 kg. Fifty percent of neonates were on ventilatory and inotropic support. All neonates were operated using surgical technique "end-to-end" or extended "end-to-end" in case of aortic arch hypoplasia. All neonates with isolated coarctation of the aorta survived; with leading heart pathology mortality was 14.3%. From 26 operated neonates 2 had recoarctation, 1 - reoperation and 2 - balloon aortoplasty. Our patients were free from spinal chord ischemia and brain damage.

Neonatal coarctation of the aorta needs an urgent surgical treatment. Surgery remains a gold standard for the treatment of aorta coarctation. Preferable technique is "end-to-end" anastomosis or extended coarctation resection with "end-to-end" anastomosis for hypoplastic aortic arch. Associated cardiac pathology increases risk of operation.