[Isolated coarctations of the aorta. Early repair by aortoplasty with the left subclavian artery. 15 cases].

When medical treatment is ineffective, isolated aortic coarctation must sometimes be surgically repaired during the first months of life. For these early operations the Crafoord resection-anastomosis technique seems to be disappointing, with a high recurrence rate. Between 1979 and 1983, 15 infants under 6 months of age underwent repair of their coarctation by a different technique: longitudinal aortoplasty using the left subclavian artery. One child died of septic rupture of the aorta, and another was lost sight of. The remaining patients were examined 35 +/- 15 months after surgery. The blood pressure usually returned to normal with no pressure gradient, at rest, between the right upper limb and the lower limbs. One child, however, had a slight (10 mm Hg) residual gradient corresponding to discreet alterations at two-dimensional echocardiography. These good results at rest after aortoplasty seem to be better in medium term than those of resection-anastomosis. The left subclavian flap aortoplasty appears to be the technique of choice in children under 6 months for the treatment of isolated coarctation.