Considerations in the surgical management of infantile coarctation of aorta.

The American Journal of Cardiology
J P ConnorsC S Weldon

Abstract

The results of a recent 5 year experience with resection of coarctation of the aorta in infants less than 1 year of age are compared with those of an earlier series from the same institution. The significant improvement in mortality and morbidity statistics is attributed to modifications in operative and postoperative care. Operative mortality has decreased from 38 to 17 percent and the incidence rate of significant restenosis has diminished from 60 to 33 percent. It is suggested that in patients with large associated intracardiac shunt banding of the main pulmonary artery should be performed before resection of the coarctation. Three of five patients have survived procedures performed in this sequence. Microsurgical techniques and careful approximation of the aortic lumen with interrupted sutures are the major factors responsible for the reduced incidence of recoarctation. Prolonged ventilatory support postoperatively with the occasional addition of controlled positive airway pressure and continued aggressive medical therapy for heart failure are recommended.

References

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Citations

Oct 1, 1979·The American Journal of Cardiology·W H FlemingP K Mooring
Jul 1, 1980·American Journal of Surgery·J H Wittig, D G Mulder
Jul 1, 1992·Journal of the American College of Cardiology·J K ParkW M Gersony
Jul 1, 1981·The Annals of Thoracic Surgery·A C PetersonA P Rocchini
Dec 1, 1981·The American Journal of Cardiology·R H BeekmanA Rosenthal
Apr 1, 1979·The American Journal of Cardiology·R R LiberthsonW M Daggett
Sep 1, 1985·Current Problems in Surgery·W H Merrill, H W Bender
Dec 1, 1979·American Journal of Surgery·J E CheathamR C Elkins
Jan 1, 1977·Circulation·W H NechesR L Hardesty
Jun 1, 1977·Pediatric Annals·J W SigmannE W Spooner
Jan 1, 1979·Scandinavian Journal of Thoracic and Cardiovascular Surgery·H B Laursen, P Lomholt
Dec 1, 1984·Annals of Tropical Paediatrics·J KishanN A Mir

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