Gross and Hufnagel (1945) and Crafoord and Nylin (1945) independently reported successful repair of the coarctation of aorta. Since then many thousand patients have had surgical correction of this anomaly (Bailey, 1957;Campbell and Baylis, 1956;Cleland et al., 1956;Keith, Rowe, and Vlad, 1958 Group B, 123 patients were operated on between 1 and 15 years of age. Patients in Group A were followed from 6 months to 11 years with a mean follow-up of 5 1 years. Of the 123 patients in Group B, 32 were followed from 6 months to 11 years with a mean follow-up of 4-4 years. Blood pressures in the right arm and one of the lower extremities were measured by the conventional blood-pressure cuff and checked by an oscillometer when necessary in infancy (Keith et al., 1958). Of the infants in Group A, 24 per cent and of the children in Group B, 26 per cent had some associated cardiac defect. Patent ductus arteriosus was the most common anomaly found in conjunction with coarctation, The other anomalies included ventricular septal defect, atrial septal defect, aortic stenosis, aortic regurgitation endocardial fibro-elastosis, and mitral regurgitation (Glass, Mustard, and Keith, 1960). RESULTSGroup A Infants. Of these infants, 82 per cent had arm pressures well above the normal limits before operation while the others had arm pressures at the upper limits of normal range. In all the pressure was higher in the arm than in the leg. At the last examination, at varying intervals after surgical correction, 67 per cent had normal pressures in the right arm, while 33 per cent still had readings that were slightly or moderately above the normal limits for the age (Fig. 1). Of these patients, 44 per cent had higher residual systolic pressures in the legs, 26 per cent had equal pressures in the arms and legs, and 30 per cent had higher pressure in the arms. In the latter group only 3 of the 7 patients had systolic pressures in the arms over 120 mm. Hg, and
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