Coarctation Of Aorta In Neonates Research Articles

Perioperative management of neonatal aortic isthmic coarctation.

Aortic isthmic coarctation is a common cardiovascular cause of neonatal mortality. This study reviews retrospectively sixty-one consecutive neonates operated on for this condition at the Royal Children's Hospital, Melbourne, in the years 1978-1983 inclusive. In this series, the overall mortality has fallen from 50% and 67% in 1978 and 1979 respectively, to 11% in 1983. In the last three years of this review, there have been no early hospital deaths and the late deaths relate to associated congenital anomalies. The decrease in mortality is ascribed to methods of perioperative support, non-invasive cardiac investigation, and surgical repair with subclavian aortoplasty. Prior to surgery, all infants are paralysed, mechanically ventilated and infused with prostaglandin E1 to reopen the ductus arteriosus, and dopamine to support the failing myocardium. The physical status of all infants improved with these maneuvres. This paper reviews the pathophysiology of neonatal aortic coarctation, the current modes of management, results and complications.

S-3-3 当院における新生児・乳児の大動脈縮窄症手術の反省と展望

S-3-3 当院における新生児・乳児の大動脈縮窄症手術の反省と展望

S-3-16 新生児・乳児の大動脈縮窄症に対する手術

S-3-16 新生児・乳児の大動脈縮窄症に対する手術

S-3-13 新生児・乳児の大動脈縮窄症

S-3-13 新生児・乳児の大動脈縮窄症

Correction of Aortic Coarctation in Neonates: Mortality and Late Results

To determine those factors that affect mortality and to analyze long-term results, the records of 44 infants who underwent repair of aortic coarctation at less than 90 days of age were examined. There were 14 operative and 8 late deaths (mean, 4.3 months postoperatively). Subsequent operation, generally to repair or palliate associated anomalies, was required 22 times in 20 patients and was a source of considerable mortality. There is evidence that earlier total repair of associated anomalies might improve survival. Sufficient data were available on 17 of the 22 survivors to assess long-term results. The outcome was considered excellent in 8 patients, fair in 4, and poor in 5. Revision of the coarctation repair due to growth failure of the anastomosis was required in 1 patient. Aggressive surgical management is recommended in these infants because, despite a high early mortality, a considerable proportion of excellent results can be anticipated in what is otherwise a hopeless situation.