[Surgical treatment of critical aortic isthmus stenosis in infancy].

Early and late results of 43 infants (35 under 3 months of age) who underwent different surgical repairs (29 Waldhausen subclavian flap method, 11 resection and end-to-end-anastomosis, 1 Clagett method, 2 Goretex patch) for coarctation of the aorta during the years 1970-1982 are reported. Only one patient had isolated coarctation, five patients had coarctation with patent duct (PDA). Associated cardiac anomalies were found in 37 patients. 17 (39,5%) infants died early after surgery. All were under 3 month of age with severe cardiac anomalies (16x intracardiac, 1x PDA). There were two late deaths after correction of intracardiac defects. In 6 out of 24 surviving patients restenosis developed 1-10 years after repair (3 of 6 patients with end-to-end-anastomosis = 50%, 2 of 10 patients with subclavian flap method = 20%, 1 patient with Goretex-patch). Our results show that coarctation with associated cardiac anomalies in patients under 3 month present higher surgical risk. Subclavian flap technique ist the method of choice for preductal coarctation. Technical difficulties related of this method are discussed in detail.