The cases of 110 infants less than 1 year of age, who had surgical repair for coarctation of the aorta between June 1974 and February 1988, were analysed. Three groups of patients were identified. In group 1 there were 39 patients with isolated coarctation. In group 2 there were 25 infants with additional ventricular septal defects (VSD), while in group 3 there were 46 infants with other associated congenital cardiac defects. Repair was performed using the subclavian flap aortoplasty (SFA) procedure in 83 patients, resection with end-to-end anastomosis (EEA) in 23, patch aortoplasty in 3 and Goretex tube bypass in 1. Twenty-eight patients had simultaneous pulmonary artery banding and one concomitant closure of the VSD. The overall early mortality rate was 8.2% (5.1% in group 1, 0% in group 2, and 15.2% in group 3). Age at operation (under 1 month, p = 0.04) and other associated cardiac anomalies (p = 0.03) increased early mortality significantly. There were 11 late deaths (10.8%) among 101 patients followed from 1 to 15 years (mean 5.3 years). Twelve patients underwent further surgery for recoarctation, eight of them within 11 months. A further 11 patients currently have a Doppler gradient across their coarctation site of more than 20 mmHg, but have not undergone further surgery to the coarctation repair site.
sewn to a Dacron tube graft to fabricate a valved conduit in 45 patients. Composite grafts were used in remaining 5 patients.Results: Average hospital stay was 13 days. There were 5 re explorations, 4 for bleeding and 1 for pericardial effusion. There were 7 early mortalities (5 of which were emergenecies), 4 due to uncontrolled bleed, 2 to myocardial pump failure and 1 due to stroke. 40 patients are in functional class (FCI), one had a stroke and another had CHF. All fabircated valved conduits were functioning well and showed similar results as the composite graft.
Conclusions:Elective aortic root replacement can be performed with a low operating risk using an on table fabricated valved conduit and the long term results are similar to composite grafts. On table fabricated valved conduit can be a low cost alternative to composite graft.
sewn to a Dacron tube graft to fabricate a valved conduit in 45 patients. Composite grafts were used in remaining 5 patients.Results: Average hospital stay was 13 days. There were 5 re explorations, 4 for bleeding and 1 for pericardial effusion. There were 7 early mortalities (5 of which were emergenecies), 4 due to uncontrolled bleed, 2 to myocardial pump failure and 1 due to stroke. 40 patients are in functional class (FCI), one had a stroke and another had CHF. All fabircated valved conduits were functioning well and showed similar results as the composite graft.
Conclusions:Elective aortic root replacement can be performed with a low operating risk using an on table fabricated valved conduit and the long term results are similar to composite grafts. On table fabricated valved conduit can be a low cost alternative to composite graft.
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