[Coarctation of the aorta associated with interventricular communication]

The association of coarctation of the aorta (CoAo) and ventricular septal defect (VSD) reaches a high mortality rate of approximately 75% in the first year of life without surgical treatment. We present our experience in the study of twenty cases with this combination of congenital heart defects with ages varying from 5 days to 13 years; half of them were under 6 months of age: there was a slight female predominance. Congestive heart failure was the first clinical manifestation in 75% of the patients; all of them showed clinical evidence of VSD with pulmonary hypertension. Twelve patients were surgically treated; in five, a subclavia flap technic was used; in another five, a rhomboid patch was placed at the site of CoAo and in the remaining two, the repair was done by end to end anastomosis. Banding of the pulmonary artery was performed in two cases and both survived; in three cases, in which the CoAo and VSD repair was done simultaneously, only one survived. We have an overall surgical mortality of 25%. Due to the short follow-up we have been unable to determine which cases may require reoperation later in life.