Original article: cardiovascularIs extended arch aortoplasty the operation of choice for infant aortic coarctation? Results of 15 years' experience in 181 patients
Section snippets
Material and methods
From January 1, 1986, to June 30, 2002, 181 infants less than 1 year old underwent repair of CoA using EAA. The median age was 13.5 days (range 1 to 300 days). The median weight at operation was 3.7 kg (range 0.85 to 10.5 kg). Congestive heart failure was present in 164 patients (91%). All patients were treated with medical therapy first, including prostaglandin infusion, with correction of acid-base balance and ventilation if necessary. A total of 135 infants (74%) were neonates.
The patients
Early results
The hospital mortality for the entire series was 0.5%; this single death occurred in a patient from group 3 with univentricular heart, double-inlet left ventricle, and associated pulmonary artery banding. No patients in group 1 or 2 died. Complications occurred in 5 (2.7%) patients, 2 infants required plication of left hemi-diaphragm because of left phrenic nerve palsy at 4 weeks postoperatively. Chylothorax occurred in 3 infants, which settled with chest tube drainage and a medium-chain
Comment
Neonates and infants with CoA generally present in congestive cardiac failure and at times are critically ill. Thanks to today's perioperative therapy, especially use of prostaglandin E1 to maintain ductal patency and distal body perfusion, these patients come to surgery in optimum condition. The mortality rate of all types of neonatal and infantile coarctation has decreased in recent years. However, much debate continues on the choice of repair technique, and the outcome is best measured not
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