Repair of coarctation of the thoracic aorta without resection. Patch graft aortoplasty. Follow-up study of 46 cases.

Two hundred and seventy-six patients (276) over the age of one were operated for coarctation of the thoracic aorta from 1949 to 1972. Patch graft aortoplasty, rather than resection of the coarcted segment was the operation of choice in forty-six patients. No hospital or late deaths occurred in this group of patients. Associated defects were present in 20% of these cases. The first patch aortoplasty was performed in 1962. The follow-up study covers a period of 12 years. Haemodynamic study and aortography were performed to assess the long term results. There was no evidence of recoarctation in the follow-up period up to 14 years following surgery and the pressure difference across the repair varied between a minimum of 5 mmHg to 18 mmHg (Table 2). The technique of patch aortoplasty without resection as been extended to a large number of patients and seems to be a very important factor in avoiding a circular constricting anastomosis, preventing the growth of the anastomosis. Maintaining the whole wall of the aorta may also influence the further growth and prevent recurrence in infants and children. Very little surgical dissection is required and suture line tension is also avoided. The technique of patch aortoplasty should be recommended in infants, children and adults with difficult and hazardous dissection.