[Late results of the surgical treatment of aortic isthmus stenosis by patch-plasty].

To assess long-term outcome after repair of coarctation of the aorta by the patch graft technique of Vossschulte, analysis of the follow-up studies of 66 patients was carried out. At the time of operation, all patients were older than one year of age, mean age 14.4 years (range 1 1/2 to 58 years). The follow-up examinations were performed at a mean of nine years (range five to 17 years) after surgery. Angiographic studies were carried out in all patients with hypertension (ten cases) as well as in those who had undergone surgery ten or more years previously (19 cases). Hypertension was attributed to recurrence of the stenosis in two patients, renal factors were considered responsible in three and in five patients the hypertension was regarded as essential. No patient showed evidence of aneurysm at the site of repair. The fact that this finding is in contrast with the results of other investigators seems most likely related to the surgical technique employed in which the integrity of the intimal membrane is vigently respected to avoid changes in the structure of the aortic wall.