Treatment of Coarctation of the Aorta with Subclavian Flap Aortoplasty in Infants.
- Author:
Joon Hyuk KONG
;
Eung Bae LEE
;
Joon Yong CHO
;
Sang Hoon JHEON
;
Bong Hyun CHANG
;
Jong Tae LEE
;
Kyu Tae KIM
- Publication Type:Original Article
- MeSH:
Aorta, Thoracic;
Aortic Coarctation*;
Arm;
Constriction;
Humans;
Incidence;
Infant*;
Infant, Newborn;
Ischemia;
Paraplegia;
Prevalence;
Recurrence;
Replantation;
Subclavian Artery;
Survivors
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2000;33(8):623-629
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty (SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. MATERIAL AND METHOD: Between 1986 and 1998, a total of 25 patients less than 1 year of age (12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0+/-3.0 months (mean +/- standard deviation); mean weight was 5.0+/-1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one (84%) of 24 hospital survivors were followed for 26.0+/-24.0 months. The risk of recoarctation in neonates (33.3%) was a little greater than infants (25.0%) without statistical significance. CONCLUSION: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment (combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.
