Isolated Aortic Coarctation in Neonates and Infants: Results of Resection and End-to-End Anastomosis
Section snippets
Patients
Neonates (<1 month of life) and infants (1 to 12 months) who underwent repair for isolated coarctation in the period between January 1987 and December 1993 were enrolled in this study. For the 46 patients who were included, all hospital records, catheterization data, and operative protocols were reevaluated for retrospective analysis. During the study period, all patients were operated on by the same surgeon (G.Z.) using basically the same operative approach. To better study the effect of
Patient Characteristics
Forty-six patients were operated on for aortic coarctation without hemodynamically relevant associated intracardiac lesions during the study period and had recent follow-up evaluation available. Thirty-four (74%) of the patients were male and 12 (26%) were female. Twenty-six patients were operated on in the neonatal period, with a mean age at operation of 12 ± 8 days (range, 3 to 29 days) and a mean weight at operation of 3.5 ± 0.5 kg (range, 2.7 to 4.5 kg). The other 20 patients were operated on
Comment
Operation is the treatment of choice for symptomatic native aortic coarctation in neonates and infants. Primary balloon dilation of coarctation has been successful in relieving the stenosis, but recent observations showed a higher rate of restenosis after balloon dilatation than after operative treatment in neonates [1] and in infants [9].
As for operative therapy, especially in neonates and infants, there is an ongoing debate about the ideal operative technique to achieve the lowest rate of
Invited Commentary
Doctor Pfammatter and his associates have presented an excellent series of neonates and infants with isolated coarctation and have demonstrated that resection with end-to-end anastomosis undoubtedly is of great value as an operative technique. There is no dispute about this conclusion, and many of our colleagues would agree. I would like to expand their observations as this report nicely demonstrates the need to view coarctation as an entity with a wide spectrum. Pfammatter and associates state
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Prediction of recurrent coarctation by early postoperative blood pressure gradient
2011, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Wu and colleagues2 also reported transverse arch diameter as a risk factor for reCoA. As in the other studies, reCoA developed within the first year of operation in most of the patients who developed reCoA.1,3 Although reCoA developed in 10 of the 11 patients within the first year, reCoA developed approximately 3 years postsurgery in only 1 patient.
Repair of Coarctation of the Aorta in Infants Weighing Less Than 2 Kilograms
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