COARCTATION OF THE AORTA IN INFANTS AND NEONATES - RESULTS AND ASSESSMENT OF PROGNOSTIC VARIABLES

From 1984 until 1994, 75 consecutive patients younger than 12 months o f age were operated on for coarctation of the aorta. We retrospectivel y analyzed predictive factors for morbidity and mortality, and also in teraction between surgical precedures and recoarctation. Surgical proc edures were as follows: resection with a traditional end-to-end (E-E) anastomosis in 55 patients (73.3%), prosthetic patch aortoplasty (PPA) in 12 patients (16%) and subclavian flap aortoplasty (SFA) in 8 patie nts (10.7%). Early mortality was 9.33% (7 patients). Logistic regressi on analysis proved that age at operation, associated anomalies of hear t, type of coarctation, aortic arch hypoplasia and pulmonary banding w ere independent predictors of hospital death. Late mortality occurred ia 7 patients (10.3%). Associated anomalies of heart were an independe nt prognostic factor for late mortality. Actuarial freedom from recoar ctation at 1 year was 91% [confidence Limits (CL): 82% to 97%] and 5 y ears were 74% (CL: 67% to 86%). Immediate postrepair gradient was equa l after E-E anastomosis and other procedures. We conclude that the tre atment of first choice in the management of coarctation of the aorta i n infants is E-E anastomosis.