Kish G F, Tenekjian V K, Tarnay T J, Warden H E, Zimmermann B
Am Surg. 1981 Jan;47(1):26-30.
From 1960 to 1978, 80 patients from 2 weeks to 49 years of age underwent operations for coarctation of the aorta. Twelve patients were under 3 months old, and 68 were older. All of the infants presented with congestive heart failure and multiple cardiac defects. In the older patients, hypertension was the most common presenting symptom; 14 were asymptomatic. All patients under 3 months old received primary correction. Seven (58%) died of complications associated with other cardiac anomalies. In the older group, there was 59 primary reconstructions, six interposition grafts, and three other procedures. There were two deaths in this group. There were three re-explorations, two for bleeding and one for false aneurysm at the suture line. Seven older patients exhibited paradoxical hypertension: three developed abdominal symptoms and two required laparotomy. Three patients originally operated on during infancy developed recurrent coarctation with reoperation in two. Nine of the older patients had chronic hypertension, all of whom were operated on after age 15. Surgical correction of coarctation in infants carries a high mortality rate secondary to associated defects. The operative mortality rate in older patients is minimal, and correction should be undertaken early to prevent the long-standing complications of hypertension.
1960年至1978年期间，80例年龄从2周大至49岁的患者接受了主动脉缩窄手术。12例患者年龄在3个月以下，68例年龄较大。所有婴儿均表现为充血性心力衰竭和多种心脏缺陷。在年龄较大的患者中，高血压是最常见的症状；14例无症状。所有3个月以下的患者均接受了一期矫正。7例（58%）死于与其他心脏异常相关的并发症。在年龄较大的组中，有59例进行了一期重建，6例进行了血管移植，3例进行了其他手术。该组有2例死亡。有3例再次手术，2例因出血，1例因缝合线处假性动脉瘤。7例年龄较大的患者出现矛盾性高血压：3例出现腹部症状，2例需要剖腹手术。3例婴儿期接受手术的患者出现复发性主动脉缩窄，其中2例再次手术。9例年龄较大的患者患有慢性高血压，均在15岁以后接受手术。婴儿期主动脉缩窄的手术矫正因相关缺陷导致死亡率较高。年龄较大患者的手术死亡率很低，应尽早进行矫正以预防高血压的长期并发症。
