The surgical anatomy of the heart in tubular hypoplasia of the transverse aorta (preductal coarctation).

Two hundred nineteen hearts with preductal coarctation (tubular hypoplasia) were analyzed in the laboratory to aid in surgical correction. One hundred fourteen were without and 105 were with ventricular septal defect. We believe the following anatomic findings may be responsible for the mortality and morbidity in surgical repair. The smallness and thinness of the left atrium (40% in those hearts without and 24% in those with ventricular septal defect); the smallness and thinness of the left ventricle (46% in those without and 32% in those with ventricular septal defect); the presence of mitral stenosis (35% in those without and 24% in those with ventricular septal defect); the presence of unicuspid or bicuspid dysplastic aortic valve (49% in those without and 50% in those with ventricular septal defect); the presence of a combination of aortic and mitral stenosis (22% in those without and 9% in those with ventricular septal defect); the location of the ventricular septal defect when present; and the possibility of stenosis or insufficiency of the dysplastic aortic valve in the late postoperative period.