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Prognosis of symptomatic coarctation of the aorta in infancy

P S Hesslein, H P Gutgesell, D G McNamara

    The American Journal of Cardiology
    |January 15, 1983
    PubMed

    Insights

    Infants with isolated coarctation of the aorta benefit from medical management, delaying surgery. Those with associated defects face higher mortality and residual coarctation risks.

    Area of Science:

    • Pediatric Cardiology
    • Congenital Heart Disease

    Background:

    • Symptomatic coarctation of the aorta presents significant challenges in infants.
    • Advances in medical and surgical care have improved outcomes.
    • Predicting clinical course and individualizing treatment remain critical.

    Purpose of the Study:

    • To review a 10-year experience with symptomatic coarctation of the aorta in infants.
    • To identify factors influencing clinical course and treatment strategies.
    • To evaluate survival rates and long-term surgical outcomes.

    Main Methods:

    • Retrospective review of 97 infants with symptomatic coarctation of the aorta.
    • Analysis of patient data based on isolated defects versus associated cardiac defects.
    • Assessment of mortality, surgical timing, and late postoperative complications.

    Main Results:

    • Ten infants with isolated coarctation had successful medical management, postponing surgery.
    • Eighty-seven infants with associated defects had higher mortality (24 before/during/after surgery) and required earlier intervention.
    • Overall 8-year survival was 62%, with most deaths in the first 6 months.
    • A 32% rate of residual coarctation was observed, often linked to late hypertension.

    Conclusions:

    • Isolated coarctation allows for delayed surgical intervention with medical management.
    • Associated cardiac defects significantly increase mortality risk in infants with coarctation.
    • Residual coarctation is a notable complication impacting long-term results and hypertension.

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