Coarctation of the aorta in infants under 1 year of age.

Untreated coarctation of the aorta in infants is associated with a high mortality, reaching up to 90%. During a period of 7 years 26 infants underwent surgical repair of this condition, the youngest being 6 days old and the oldest 11 months. Two underwent emergency surgery after catheterization, while the rest had an elective or semi-elective operation. Associated anomalies were present in 85% of the whole group; of the 22 patients with anomalies, a ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were present in 11 patients, a PDA in 7, a VSD in 6, transposition of the great arteries in 3, an atrial septal defect in 3, a single ventricle in 1, a hypoplastic aortic arch in 1, a hypoplastic left ventricle in 1 and a partial anomalous pulmonary venous defect in 1. Four patients (15%) had no other associated anomaly. The surgical techniques used were coarctectomy and end-to-end anastomosis in 61,5%, subclavian flap aortoplasty in 27%, and Dacron patch aortoplasty in 11,5%. Additional pulmonary artery banding was performed in 6 patients; in 2 patients lung biopsies were also carried out in order to establish the severity of pulmonary hypertension. The overall hospital mortality was 30,7%. No patients with uncomplicated coarctation died.