2-STAGE REPAIR OF ADULT COARCTATION OF THE AORTA WITH CONGENITAL VALVULAR LESIONS

Background. Coarctation of the aorta associated with intracardiac path ologic conditions presenting in adult life poses some technical and ma nagement challenges. When deciding on the best surgical strategy, the surgeon must pay careful attention to the changes that will occur in t he circulation. Methods. In our small series of 3 patients, the intrac ardiac pathologic lesions were corrected first, and the coarctation wa s repaired as a second-stage procedure 2 to 3 months later. Results. A ll patients had an uneventful recovery from both operations. The poten tial problems of renal impairment caused by inadequate perfusion durin g bypass and perioperative systemic hypertensive complications resulti ng from coarctation of the aorta were not observed. At the time of coa rctation repair as a second-stage procedure, anticoagulation was easil y controlled. All 3 patients had short intensive care unit and hospita l stays. Conclusions. Staged surgical repair of this complex pathologi c combination in adult patients is a safe option and is easy to manage perioperatively. (C) 1997 by The Society of Thoracic Surgeons.