From January 2000 to December 2006, 84 infants and children diagnosed as
aortic coarctation with intracardiac anomaly underwent surgical treatment. Mean age of the patients was 13.5 months, with a range from 1 month to 3 years. Mean
body weight was 7.3 kg, with a range from 3.3 to 15 kg. Twelve patients complicated with complex intracardiac anomaly. Seventy-two patients complicated with
ventricular septal defect and other simple anomaly. Twenty-one patients had hypoplasia of the aortic arch. Sixty-two patients had one-stage repair.
Median sternotomy was used to simultaneously repair coarctation and intracardiac defect in 49 patients. Left
thoracotomy and
median sternotomy were applied to repair
aortic coarctation and intracardiac anomaly respectively in 13 patients. Twenty-two patients had staged repair. Operational techniques for
aortic coarctation include 42 patients of patch aortoplasty, 30 patients of resection and end-to-end anastomosis, 6 patients of subclavian flap aortoplasty, 3 patients of vascular bypass, and 1 patient of balloon dilation. In all 49 patients of one-stage operation through
median sternotomy, selective cerebral perfusion was used in 43 patients, deep
hypothermia low flow was applied in 4 patients, deep
hypothermia circulatory arrest was performed in 2 patients.
RESULTS: There were 8 hospital deaths. The mortality is 9.5%. Among 8 deaths, 3 patients were misdiagnosed.
CONCLUSIONS: Surgeries for
aortic coarctation with intracardiac anomaly have satisfactory short-term results in infants and toddlers. One-stage repair through
median sternotomy can be applied to most of the patients. Selective cerebral perfusion with deep
hypothermia and circulatory arrest in lower body can protect the brain and other vital organs.