Coarctation of the aorta. A follow-up study after surgical treatment in infancy and childhood.

Between 1951 and 1973, 138 patients aged 0 to 12 years were operated on for coarctation of the aorta. Ten of 18 infants died early. There were 3 late deaths, 2 occurred suddenly and 1 after reoperation. Three of the 125 late survivors had severe, 19 had slight symptoms, while 103 had no complaints, 3 of whom refused examination. The remaining 122 cases were examined between 2 and 24 years (mean 10.9 years) after the operation. Two patients had sequelae from an operative spinal cord injury and 2 had late hemipareses (traumatic in one). Recoarctation, defined as arm/leg pressure gradient exceeding mmHg, totally occurred in 18.7%, and in 4 of 7 cases operated on in infancy. Hypertension without recoarctation was observed in 17.2% and associated cardiovascular anomalies in 18% of the late survivors. It is suggested that the optimal age for surgical repair of coarctation of the aorta is between 4 and 6 years of age. A long-term follow-up is recommended in all patients.