NO 5Rav. Chil. Pediatr. 57(5): 401-404, 1986 Tratamiento de la coartacion aortica en el nino mediante plastia con arteria subclavia Aortic coarctation: repair by subclavian artery flapSixty five paitients with aortic coarctation were submitted to aortoplasty with left subclavian artery flap between November 1977 and January 1985. Their age range at surgical repair was 7 days to 10 years and 58%of them had another associated cardiac malformation. The operative mortality was 3% and it was always due to respiratory complications. Recoarctation occured in only two patients, both were less than 3 months old at the time of operation. Muscular atrophy and slower growth rate of the left upper limb were detected in only one patient in this series. This surgical procedure is our first choice in pediatiic patients with coarctation of the aorta because of its low mortality rate and few late complications. (Key words: Aortic coartation, surgical repair, subclavian artery flap).La coartacion aortica (Co Ao) representa 5% a 10% de todas las malformaciones congenitas cardiovasculares. Si bien su correccion quinirgica debe ser hecha idealmente entre los 2 y 4 anos de edad, el defecto suele producir en el lactante insuficiencia cardiaca de diffcil manejo medico, obligando a intervenir antes de las edades sefialadas 1 -2 . La reparacion quirurgica empleando reseccion del segmento coartado y anastomosis termino-terminal tiene, antes de la edad de 2 anos, el inconveniente de alta incidencia de recoartacion (20 a 35 %) 3 ' 4 . For esta razon se ha propuesto usar una tecnica de plastia aortica mediante un colgajo de arteria subclavia izquierda obtenido despues de seccionar distalmente esta ultima y abrirla en canal 5 ' 6 -7 (Fig.). Con esta tecnica se consigue aumentar el lumen aortico sin usar elementos extranos, evitando al mismo tiempo las estrecheces residuales que suelen ocurrir en las anastomosis perpendiculares o termino-terminales 5 .Este informe se refiere a los resultados clfnicos y seguimiento de 65 nitfos cuya Co Ao fue reparada mediante plastia de subclavia en los ultimos 8 afios.
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