Should elective repair of coarctation of the aorta be done in infancy?
Our experience with the subclavian flap repair for coarctation of the aorta over the past 10 years includes 53 patients under 1 year of age. Of this group, 35 were newborn infants. All but two had an associated patent ductus arteriosus and 23 (66%) had associated intracardiac anomalies. All neonates had severe congestive heart failure and operation was carried out promptly after they were stabilized with diuretics and inotropic agents. Prostaglandin infusions have been essential to the care of many of these patients. Operative mortality was two of 53 patients (4%). No patient more than 4 days old operation has died, and concomitant pulmonary artery banding was performed in five infants with no deaths. Running nonabsorbable suture was used in 21 patients, interrupted nonabsorbable suture in 23, and continuous monofilament absorbable suture in the last nine. Mean follow-up time has been 46 months. Invasive follow-up studies, performed in 11 patients, have revealed residual systolic gradi