RESULTS OF SURGICAL-TREATMENT OF COARCTATION OF THE AORTA IN THE CRITICALLY ILL NEONATE - INCLUDING THE INFLUENCE OF PULMONARY-ARTERY BANDING

  • 1 May 1986
    • journal article
    • research article
    • Vol. 91  (5) , 732-737
Abstract
During a 7 year period, 64 consecutive neonates (less than 30 days of age) underwent surgical repair of coarctation of the aorta. There were no intraoperative deaths, four (6%) postoperative deaths, and seven (12%) late deaths. Improvement in the survival rate in survival rate in this study can be attributed to (1) improved perioperative care, (2) avoidance of hypothermia during the operation, (3) use of prostaglandin E1 to stabilize the patient''s condition before the operation, (4) emergency cardiac catheterization and operations, (5) adequate relief of the aortic obstruction, and (6) appropriate use of pulmonary artery banding. The last of these factors may further reduce the mortality. Banding of the pulmonary artery in patients with complex cardiac lesions associated with a ventricular septal defect has significantly lowered the mortality compared with the mortality of those without pulmonary artery banding. In contrast, the absence of pulmonary artery banding in those with a large ventricular septal defect did not affect the mortality of postoperative ventilator requirements as compared to patients having banding and coarctation repair. One late death was related to complications of the pulmonary artery band.