Coarctation of the aorta in infants under one year of age: with particular reference to results of surgery
South African Medical Journal, Volume 48, No. 10, Year 1974
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During the 10 year period 1962-1971, coarctation of the aorta was diagnosed within the first 5 months of life in 35 hospital cases. Of these, 29 (83%) were symptomatic, and 18 (54%) underwent surgery to correct the coarctation. Thirteen of the 18 patients (72%) survived the procedure. Of the 5 patients who died, 2 had single ventricle complexes, and 1 had an associated ventricular septal defect and died at a subsequent operation for pulmonary artery banding. One patient who survived had a thoracotomy with no procedure done to the aorta. All survivors were followed up for at least 1 year. Residual gradients were found in 6 of the 12 patients (50%), but classified as severe in only 2 cases. Of the 11 patients who were symptomatic but who did not undergo surgery, 7 died (mortality 63%). There were 6 remaining patients who were asymptomatic. There have been 3 deaths in this series all unrelated to their cardiac pathology. It is strongly recommended that young babies with coarctation of the aorta, who develop congestive cardiac failure, undergo 36 to 48 hr of medical therapy, after which surgical resection of the coarcted segment is carried out. This approach offers the best prospects for survival.