JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Nair, U. R.
Right arrow Articles by Walker, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nair, U. R.
Right arrow Articles by Walker, D. R.

The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 587-590, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Surgical management of severe coarctation of the aorta in the first month of life

UR Nair, O Jones and DR Walker

Between March, 1978, and April, 1982, 48 neonates under 4 weeks of age were operated upon for severe coarctation of the aorta in our unit. Of these, 36 babies were in severe congestive cardiac failure and 11 had renal failure. Angiocardiography and echocardiography demonstrated intracardiac lesions in 29 patients. All had a patent ductus arteriosus. Surgical relief of the coarctation was effected within 48 hours of diagnosis. Those in severe cardiac and renal failure were intubated and ventilated in the intensive care unit before the operation. Continuous monitoring of the central venous and arterial pressures and rectal and skin temperature and periodic checks on the acid-base status were instituted, and acidosis was corrected carefully with a 4.2% solution of sodium bicarbonate. A dopamine infusion (4 to 8 micrograms/kg/min) was used to assist the renal and cardiac functions. Five babies were treated with prostaglandin E for 24 to 46 hours before the operation. Forty-five patients had subclavian flap repair of the coarctation and the other three had repair by polytetrafluoroethylene (PTFE) patch angioplasty. The patients were ventilated for 1 to 8 days postoperatively. Dopamine support was given to all the immediate postoperative period. Three patients with associated cardiac lesions died in the first 48 hours after operation. Three other patients died on the sixth, eighth, and eleventh postoperative days of noncardiac causes. Of the 42 survivors, three required revision of the repair because of restenosis 3 to 18 months later. Three patients with ventricular septal defect had closure of the defect within 8 months after birth. We believe that coarctation of the aorta presenting soon after birth should be treated by a combination of active resuscitation and early surgical relief, and that continuous monitoring for early detection and correction of hypoxia and acidosis is essential to achieve satisfactory results.


This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Cobanoglu, G. K. Thyagarajan, and J. L. Dobbs
Surgery for coarctation of the aorta in infants younger than 3 months: end-to-end repair versus subclavian flap angioplasty: is either operation better?
Eur. J. Cardiothorac. Surg., July 1, 1999; 14(1): 19 - 26.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1983 by The American Association for Thoracic Surgery.