Coarctation of the aorta

Abstract

In a series of 70 patients who had surgical correotion of coarctation of the aorta between 1952 and 1969, the operative mortality was 7% and the complication rate was 14%. The mortality was particularly high in adult males over 30, with pre-operative evidence of left ventricular ischaemia. Simple surgical procedures had satisfactory results, but the use of prostheses carried a high risk, and turning down the left subclavian artery failed to lower the blood pressure. The blood pressure score fell by 68% after operation, and by a further 8% following discharge from hospital. This result was maintained up to 17 years after operation, and may be expected in all groups of patients.Coarctation of 'the aorta has been surgically treated with success since 1945 (Crafoord and Nylin, 1945; Gross and Hufnagel, 1945). As varying techniques and results are reported from different centres it was considered timely to review the experience at this centre with 70 patients, spanning 17 years. The results have been analysed with regard to the rate of post-operative mortality and complications, the effect of specific operative procedures and the lowering of systolic blood pressure immediately following, and up to 17 years after surgery. CLINICAL MATERIALThese 70 patients include males and females of all age groups (Fig.

Incidental detection of late presenting co-arctation of the aorta on chest x-ray: the importance of rib notching

“…Some 75% of these 43 subjects had recognisable rib notching, giving a false negative rate of 25%. More recently, signs of a collateral circulation (rib notching and/or a visible internal thoracic artery) were seen in 26/38 patients with co-arctation of the aorta (68%, indicating a false negative rate of 32%)7 in one study, rib notching was seen in 39/61 patients (64%, false negative rate of 36%) in another8 and there is also case report evidence of co-arctation of the aorta without rib notching 9. These reports of false negative results of rib notching demonstrate limits to its sensitivity, but there are also reports that rib notching has limited specificity for co-arctation of the aorta despite a lack of numerical data.…”

Extensive spinal epidural hematoma: a rare complication of aortic coarctation

“…Bilateral upper rib notching and ªfigure 3º sign at the lateral contour of aortic arch are also seen poststenotic parts of the thoracic aorta, is one of the typical signs of coarctation. Collateral vessels may form aneurysmal dilatations due to muscle and elastic tissue deficiency manifested on the background of longstanding arterial hypertension, which can lead to their rupture [3,4].…”

Successful outcome of complications of excision of aortic coarctation.

“…Wisheart (1970) described two patients who developed hoarseness of the voice postoperatively. A significant feature of our case is the degree of recovery that took place in the character of the voice.…”