Coarctation repair in children with Turner's syndrome

Ravelo recently reported the results of surgical repair of coarctation of the aorta in eight patients with Turner's syndrome. Three of these patients had serious hemorrhagic complications. At Texas Children's Hospital, we have operated on four patients with Turner's syndrome and coarctation of the aorta without complications. Of the 12 patients in both series, nine patients had uncomplicated courses when they had Dacron aortoplasty (4/12) or end-to-end anastomosis (5/12). The three other patients with end-to-end anastomoses had significant perioperative hemorrhage. Whereas Ravelo reported serious complications in 38% (3/8), the combined series suggest that only about 25% (3/12) of patients with Turner's syndrome undergoing repair of coarctation of the aorta may experience significant perioperative hemorrhage. We conclude, as did Ravelo, that attention to technical details should keep surgical morbidity in these patients to a minimum.