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[Aortic coarctation and complex heart disease. Surgical treatment during the first year of life]
A E Fiane1, H L Lindberg, E Seem
1Kirurgisk avdeling A, Rikshospitalet, Oslo.
Insights
A staged surgical approach remains the standard for complex coarctation of the aorta in neonates and infants. This method, involving initial correction and further procedures as needed, showed significant mortality rates but is still recommended.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Defects
Abstract:
During the five years 1990 through 1994, 70 neonates and infants had surgery for coarctation of the aorta. 30 patients with complex coarctation of the aorta underwent a first stage correction with supplementary ductus ligation and pulmonary artery banding as needed. The mode of surgical repair of coarctation was end-to-end anastomosis in ten patients and patch graft in 20 patient. Mean follow-up was 766 (range 3-1812) days. Mortality after primary procedure was 16.6% (5/30) and after secondary procedure 11.1% (2/18). Three surviving patient developed recoarctation, but only one patients needed re-operation. In spite of improvement in neonatal cardiac surgery, we conclude that a staged approach is still the current treatment in most cases of complex coarctation of the aorta.