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[Results of coarctectomy in newborn and young infants]
Insights
Infant coarctectomy has low mortality. Proper surgical technique ensures normal growth at the coarctation repair site, leading to asymptomatic survivors.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
Background:
- Coarctation of the aorta is a congenital heart defect requiring surgical intervention.
- Early surgical repair in infants is crucial for long-term outcomes.
Purpose of the Study:
- To evaluate the outcomes of coarctectomy in infants.
- To assess the long-term results and potential complications of the procedure.
Main Methods:
- Retrospective review of 20 infants undergoing coarctectomy between 1972 and 1979.
- Analysis of operative mortality, need for subsequent surgeries, and long-term follow-up.
- Assessment of blood pressure gradients and postoperative catheterization findings.
Main Results:
- Overall operative mortality was 5% (1 death).
- 12 of 15 survivors were asymptomatic at a mean follow-up of 3 years.
- Two patients showed recoarctation, confirmed by pressure gradients and catheterization.
Conclusions:
- Coarctectomy in newborns and infants now has low operative mortality.
- Appropriate surgical techniques promote normal anastomotic site growth and good long-term results.
Abstract:
Twenty infants underwent coarctectomy between 1972 and 1979, 12 were less than one month old at surgery. One infant died after the procedure (5% mortality). Seven underwent open heart surgery later in the first year of life for associated intracardiac defects; there were 3 early and one late death. Of the 15 survivors, 12 have been followed up for 6 months to 6 years (mean 3 years). All are actually asymptomatic. Arterial blood pressure is slightly higher in the leg than in the arm in 8 patients (as in normal children), equal in leg and arm in 2 and lower in the leg than in the arm in 2 (recoarctation). Postoperative catheterization was done in six patients. A pressure gradient across the anastomotic site was confirmed in two (32 and 28 mm Hg). In the other four, no pressure gradient was found, and the site of the anastomosis was hardly or not at all detectable on the angiogram. Coarctectomy in newborns and infants now carries a low operative mortality. With proper operative technique, normal growth of the anastomotic site is usually obtained.