Influence of Associated Defects and Type of Surgery in Neonatal Aortic Coarctation

Abstract

We reviewed our 12-year experience of surgical treatment for aortic coarctation in 86 neonates. Twenty-three patients had simple coarctation, 38 had an associated large ventricular septal defect, and 25 had complex intracardiac defects. The surgical techniques included subclavian flap angioplasty in 54 (63%), combined resection with end-to-end anastomosis augmented by a subclavian flap in 22 (26%), resection with extended end-to-end anastomosis in 7 (8%), and patch aortoplasty in 3 (3%). Five patients required additional transverse aortic arch augmentation. Hospital mortality was 14% (12/86) and was not related to the type of repair but associated pathology increased the operative risk. Late mortality was 11% (8/74) within one year of repair. Recoarctation developed in 5 patients (7%) within one year. No recoarctation was observed in the group repaired by end-toend anastomosis augmented by a subclavian flap (p = 0.04).

Accuracy of Current Non-invasive Methods in Estimating Aortic Coarctation Gradients

“…According to severity, patients either will be sent to cardiac catheterization (cath) to assess the gradient across the coarctation and decide on the need for any intervention such as balloon dilation or stent angioplasty. On different occasions especially in neonates and some infants, patients will go directly to surgery [4][5][6].…”