Coarctation of the aorta in the first year of life
Su, W.J.; Liao, P.K.; Chang, C.H.
Journal of the Formosan Medical Association 86(9): 965-970
1987
ISSN/ISBN: 0371-7682 PMID: 3694168 Document Number: 289166
From January 1978 through December 1985, 20 infants were diagnosed to have coarctation of the aorta or interruption of the aortic arch by cardiac catheterization at the Pediatric Department of Chang Gung Memorial Hospital. Four patients who had associated complex congenital heart diseases or prematurity were excluded. Our material consisted of the remaining 16 cases. The ages ranged from 10 days to 10 and 1/2 months (mean 13 weeks); 8 patients (50%) were newborn and 12 (75%) below age of 6 months. They weighed from 2.6 to 6.2 kg (mean 3.8 kg). All cases were associated with either a patent ductus arteriosus or ventricular septal defect, or most frequently, both. One patient had discrete subaortic stenosis and 3 other cases were combined wtih bicuspid aortic valve. Fifteen cases underwent operations which consisted of patch angioplasty in 4, resection and end-to-end anastomosis in 3, resection and tube graft interposition in 1, and subclavian flap angioplasty in 3. Subclavian artery-descending aorta anastomosis was performed in all of the 3 patients who had type A interruption with 1 death. Another patient with type B interruption, in whom it was impossible to reach the proximal aortic portion during operation, expired surgery. Among the 13 survivors, one had recoarctation with 50 mmHg of systolic pressure gardients and received a second operation with a bypass graft from the ascending aorta to the descending aorta. All patients had normal upper extremity blood pressure at their most recent evaluation, 8 months to 8 years (mean: 47 months) after the surgery. The resting systolic pressure gradient between the upper and lower extremities ranged from 10 to 28 mmHg.