COMPARISON OF DIFFERENT OPERATION TECHNIQ UES AND SUTURE MATERIALS FOR THE REPAIR OF COARCTATION OF THE AORTA IN INFANCY

Clinical examination and Doppler ultrasound were performed in 31 child ren after repair of coarctation of the aorta. Median postoperative fol low-up period was 4.5 years. The aim of our study was a comparison of different operation techniques and suture materials. In 16 infants sub clavian flap repair had been performed using polydioxanone absorbable sutures (PDS(R)) in 8 cases and polypropylene (Prolene(R)) sutures in the other 8 cases. Resection and end-to-end repair had been carried ou t in 8 infants using PDS(R) and in 7 using Prolene(R) sutures. Doppler echocardiographically derived gradients across the reconstructed aorta were significantly lower in infants operated with the subclavian flap technique (p < 0.05). The length of the arm on the side of the subcla vian flap operation was shorter (median 1.2 cm), but there were no sig ns of ischaemic complications. Using PDS(R) sutures the aortic arch an d the aortic isthmus were each morphologically significantly wider in both operation techniques. Noninvasive two-dimensional echocardiograph y demonstrated good anatomical repair and no anastomotic aneurysm form ation after aortic repair using polydioxanone. Conclusion: Regarding t he dopplerechocardiographically derived gradients in the anastomotic r egion this intermediate follow-up study reveals better results using t he subclavian flap technique; absorbable polydioxanone sutures favour normal growth of the anastomotic site without vascular complications.