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Ann Thorac Surg 1979;28:346-353
© 1979 The Society of Thoracic Surgeons

Articles

Aortoplasty Compared with Resection for Coarctation of the Aorta in Young Children

Robert M. Sade, M.D.*, Ashby B. Taylor, M.D., Edd P. Chariker, M.D.

Section of Pediatric Cardiac Surgery and Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC.

* Address reprint requests to Dr. Sade, 171 Ashley Ave, Charleston, SC 29403.

We repaired coarctation of the aorta in a group of 18 children less than 3 years old, using either resection with end-to-end anastomosis (8 patients, Group 1) or patch graft aortoplasty (10 patients, Group 2). The two groups were similar preoperatively in age, pressure difference between proximal and distal aorta ({Delta}PAO), and severity of aortic arch hypoplasia.

Three patients, all less than 2 months old, died early postoperatively. Among the survivors, the right brachial artery systolic pressure was significantly higher in Group 1 (133.1 ± 7.0 mm Hg) (mean ± standard error of the mean) than in Group 2 (102.5 ± 7.2 mm Hg) (p < 0.05). The {Delta}PAO was significantly higher in Group 1 (33.0 ± 7.5 mm Hg) than in Group 2 (5.1 ± 2.3 mm Hg) (p < 0.01). Three patients in Group 1 required reoperation and were treated with patch graft aortoplasty; relief of {Delta}PAO was complete in 2. Patch graft aortoplasty is more effective than resection in reducing proximal aortic systolic pressure and in relieving {Delta}PAO in infants and small children with coarctation of the aorta.




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