RECURRENT AORTIC COARCTATION - IS SURGICAL REPAIR STILL THE GOLD STANDARD

Objective: We reviewed our experience with surgical repair compared wi th balloon aortoplasty of recurrent coarctations of the aorta. Methods : This is a retrospective review of 1 institution's 27-year experience with surgical repair of recurrent aortic coarctation, A thorough char t review was performed of all pediatric patients undergoing surgical r epair for recurrent aortic coarctation (n = 56) from January 1970 thro ugh July 1996, Results: The vast majority of recoarctations were repai red with a prosthetic patch technique, with a greater than 96% success rate. No deaths or major complications occurred in the 56 patients, A lthough a direct comparison with balloon aortoplasty cannot be done, w e have reviewed the data available in the literature and found higher complication rates and lower success rates than we obtained in our ser ies. Conclusions: Although the treatment of aortic coarctation has imp roved significantly during the past decades, persistent hypertension a fter repairs at an older age and recurrent coarctation after repairs i n neonates occur in all institutions. Surgeons have not agreed on the optimal approach to primary coarctation repair, and invasive cardiolog ists have challenged operative intervention for both recurrent and pri mary coarctation. This study demonstrates that surgical repair of recu rrent coarctation of the aorta call be performed safely and with excel lent results. We believe it is still the gold standard in the manageme nt of recurrent coarctation of the aorta.