Recurrent coarctation of the aorta after successful repair in infancy

Abstract

Twenty unselected infants who survived repair of coarctation of the aorta were restudied an average of 6.2 years postoperatively. Eight patients (40 percent) showed no significant difference in blood pressures between the arms and legs and had normal pressures in their arms. These patients have been followed up for an average of 5.1 years postoperatively. Another 8 patients (40 percent) had moderate blood pressure differences between the upper and lower limbs. These patients have been followed up for an average of 6.6 years postoperatively. Further follow-up of this group will be required to determine how many will need reoperation. Four patients (20 percent), although asymptomatic, had recurrent severe coarctation of the aorta that will require reoperation. These patients have been followed up for an average of 6.9 years postoperatively. The mechanism of the recurrent coarctation is not clear, but there is evidence that the coarctation is incompletely relieved in some and that it develops with growth in others. All infants surviving repair of coarctation of the aorta must be closely followed up for possible recurrent coarctation until they reach adult size.