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Albert Starr
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Ann Thorac Surg 1977;24:544-549
© 1977 The Society of Thoracic Surgeons


Articles

Correction of Aortic Coarctation in Neonates: Mortality and Late Results

Quentin Macmanus, M.D.*, Albert Starr, M.D., Louis E. Lambert, M.S., Gary Grunkemeier, Ph.D.

Division of Cardiopulmonary Surgery, University of Oregon Health Sciences Center, Portland, OR

Accepted for publication April 1, 1977.

* Address reprint requests to Dr. Macmanus, Division of Cardiopulmonary Surgery, University of Oregon Health Sciences Center, Sam Jackson Park Rd, Portland, OR 97201

To determine those factors that affect mortality and to analyze long-term results, the records of 44 infants who underwent repair of aortic coarctation at less than 90 days of age were examined. There were 14 operative and 8 late deaths (mean, 4.3 months postoperatively). Subsequent operation, generally to repair or palliate associated anomalies, was required 22 times in 20 patients and was a source of considerable mortality. There is evidence that earlier total repair of associated anomalies might improve survival.

Sufficient data were available on 17 of the 22 survivors to assess long-term results. The outcome was considered excellent in 8 patients, fair in 4, and poor in 5. Revision of the coarctation repair due to growth failure of the anastomosis was required in 1 patient. Aggressive surgical management is recommended in these infants because, despite a high early mortality, a considerable proportion of excellent results can be anticipated in what is otherwise a hopeless situation.




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