Korean J Thorac Cardiovasc Surg.  2000 Aug;33(8):623-629.

Treatment of Coarctation of the Aorta with Subclavian Flap Aortoplasty in Infants

• Kong JH
• Lee EB
• Cho JY
• Jheon SH
• Chang BH
• Lee JT
• Kim KT

Abstract

BACKGROUND
There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty (SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. MATERIAL AND METHOD: Between 1986 and 1998, a total of 25 patients less than 1 year of age (12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0+/-3.0 months (mean +/- standard deviation); mean weight was 5.0+/-1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one (84%) of 24 hospital survivors were followed for 26.0+/-24.0 months. The risk of recoarctation in neonates (33.3%) was a little greater than infants (25.0%) without statistical significance. CONCLUSION: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment (combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.

MeSH Terms

Aorta, Thoracic
Aortic Coarctation*
Arm
Constriction
Humans
Incidence
Infant*
Infant, Newborn
Ischemia
Paraplegia
Prevalence
Recurrence
Replantation
Subclavian Artery
Survivors