SUBCLAVIAN ARTERIOPLASTY - REPAIR OF COARCTATION OF THE AORTA IN THE 1ST YEAR OF LIFE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 87  (6) , 894-900
Abstract
Between June, 1977, and Dec., 1982, 106 infants underwent subclavian flap arterioplasty for repair of coarctation of the aorta in the 1st yr of life. This technique was utilized because of previous experience with the end-to-end technique in 181 infants, in whom there was a recurrence rate of 42% at 5 yr. The recurrence rate in 78 of the 81 survivors who were followed up for a mean of 18.8 mo. .+-. 15.9 mo. (standard error) is 17.3% at 1 yr and 11.1% at 2 and 3 yr postoperatively. The presence of associated disease affects mortality: only 1 death in 34 patients with isolated coarctation; 3 deaths in 24 with coarctation plus ventricular septal defect; and 21 deaths in 45 infants with coarctation and complex lesions. The present approach in the group with coarctation plus ventricular septal defect is to repair the coarctation without banding the pulmonary artery and then to close the defect if the infant remains in failure. Operative survival was 13 of 13 without pulmonary artery banding and 11 of 14 with pulmonary artery banding.

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