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Ann Thorac Surg 1991;52:615-620
© 1991 The Society of Thoracic Surgeons

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Articles

Role of extended aortoplasty related to the definition of coarction of the aorta

^a Pediatric Cardiothoracic Surgery, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York, USA
^b Pediatric Cardiovascular Surgery, Children's Hospital of New Jersey, United Hospitals Medical Center, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA

Accepted for publication December 31, 1990.

^_* Address reprint requests to Dr Amato, Schneider Children's Hospital-372, Long Island Jewish Medical Center, New Hyde Park, NY 11042.

One hundred thirty-nine patients underwent operation for coarctation of the aorta. Age ranged from 1 day to 21 years and weight, from 1.5 to 70.4 kg. Numerous methods of repair were used. The operative mortality was low (1.3%), and 17 patients (11.3%) died late. Recoarctation occurred in 13 patients (9.4%). We attempted to correlate mortality and recoarctation with the surgical procedure. A review of the literature revealed no classifications of coarctation that applied to the anatomical and pathological variations we found at the time of operation. Therefore, we devised a surgical classification to separate the various entities in the spectrum of coarctation: type I = primary coarctation; type II = coarctation with isthmus hypoplasia; and type III = coarctation with tubular hypoplasia involving the isthmus and segment between the left carotid and left subclavian arteries. Each of these types has subtypes: A = with ventricular septal defect and B = with other major cardiac defects. We believe that rather than labeling one procedure as "the procedure of choice," providing this classification will allow the surgeon to use a method of repair that is suited to the anatomical variation.

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