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Surgical Experience of Coarctation of the Aorta in Infants and Young Children

Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children’s Medical Center, Xin Hua Hospital and Shanghai Second Medical University, Shanghai, China

For reprint information contact: Jing-Hao Zheng, MD, Tel: 86 21 5873 2020, Fax: 86 21 6515 3984, Email: haohao6554{at}hotmail.com, Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children’s Medical Center, Xin Hua Hospital and Shanghai Second Medical University, Shanghai 200127, China.

We evaluated the effectiveness of surgical treatment for coarctation of the aorta in infants and young children, based on our experience over 7 years. From March 1999 to December 2005, 168 cases of coarctation of the aorta in patients aged 21 days to 3 years were treated by end-to-end, extended end-to-end, or extended end-to-side ascending aorta and aortic arch anastomosis. The mortality rate was 0.6%. In 138 (82%) patients, the pressure in the lower extremity was higher than in the upper extremity. During 6–24 months of follow-up, hoarseness appeared in 6 patients. Echocardiography revealed stenosis of the end-to-end anastomosis in only 2 patients. We suggest that the best option for surgical treatment of coarctation of the aorta with associated cardiac malformations is a one-stage procedure using a median sternotomy approach. It is better to perform extended end-to-end anastomosis or anastomosis between the distal descending aorta and the left wall of the ascending aorta, or to extend this anastomosis to the transverse arch.