[Surgical treatment of critical aorta coarctation in neonates]. / Naujagimiu aortos koarktaciju chirurginis gydymas.

ABSTRACT

UNLABELLED Coarctation of the aorta is relatively common defect accounting for 5-8% of all congenital heart defects. Newborns very often, about in 50% of cases, are in cardiogenic shock. From 1991 to 2003, 26 neonates with coarctation of the aorta underwent surgical repair at Heart Surgery Center of Vilnius University 12 with isolated coarctation of the aorta and 14 with leading heart pathology. Age of patients was from 2 to 30 days. Weight was from 2.8 to 4.7 kg. Fifty percent of neonates were on ventilatory and inotropic support. All neonates were operated using surgical technique "end-to-end" or extended "end-to-end" in case of aortic arch hypoplasia. All neonates with isolated coarctation of the aorta survived; with leading heart pathology mortality was 14.3%. From 26 operated neonates 2 had recoarctation, 1 - reoperation and 2 - balloon aortoplasty. Our patients were free from spinal chord ischemia and brain damage. CONCLUSIONS: Neonatal coarctation of the aorta needs an urgent surgical treatment. Surgery remains a gold standard for the treatment of aorta coarctation. Preferable technique is "end-to-end" anastomosis or extended coarctation resection with "end-to-end" anastomosis for hypoplastic aortic arch. Associated cardiac pathology increases risk of operation.