Belli D C, Friedli B, Faidutti B
Helv Paediatr Acta. 1984 Aug;39(3):237-48.
Between 1972 and 1983, 29 newborns and infants were treated surgically for coarctation of the aorta. The mean age at operation was 2 months 7 days. 76% of the patients (22/29) had an associated intracardiac malformation, 8 requiring correction. The early mortality rate (due to coarctation repair) was 7% (2/29). The total mortality rate was 31% (7/29). Four of the 7 late deaths occurred during surgical correction of an intracardiac malformation. Twenty children were followed up for 1 to 10 years (mean 4 1/2 years) after surgery. Four patients (20%) had a recoarctation. All 4 recurrences occurred within 2 years after surgery, and in patients operated on during the first month of life. Blood pressure at the latest outpatient visit was above the 97th percentile in 6 children, 4 of whom had recoarctation. Among the patients with no evidence of recurrence, 86% had a blood pressure between the 50th and the 97th percentile or just above the 97th. Five patients underwent a maximal exercise test: none developed excessive elevation of systolic blood pressure, and no pressure difference appeared between arm and leg during the exercise test in those who had none at rest. Thus, early surgical correction improves the prognosis of infantile coarctation syndrome, but recoarctation may occur; long term follow-up is advisable.
1972年至1983年间，29例新生儿和婴儿接受了主动脉缩窄的外科治疗。手术时的平均年龄为2个月零7天。76%的患者（22/29）合并有心内畸形，其中8例需要矫正。早期死亡率（因主动脉缩窄修复）为7%（2/29）。总死亡率为31%（7/29）。7例晚期死亡中有4例发生在心内畸形的外科矫正过程中。20名儿童在手术后接受了1至10年（平均4年半）的随访。4例患者（20%）出现再缩窄。所有4例复发均发生在术后2年内，且均为出生后第一个月内接受手术的患者。在最近一次门诊就诊时，6名儿童的血压高于第97百分位数，其中4例有再缩窄。在无复发证据的患者中，86%的患者血压在第50至第97百分位数之间或略高于第97百分位数。5例患者进行了最大运动试验：无人出现收缩压过度升高，在静息时无压差的患者运动试验期间，手臂与腿部之间也未出现压差。因此，早期手术矫正可改善婴儿主动脉缩窄综合征的预后，但可能会发生再缩窄；建议进行长期随访。
