Isolated coarctation of the aorta: surgical treatment and late results. Eighteen years' experience.

From March 1967 to February 1985, ninety one patients aged from eleven months to 53 years underwent surgical treatment of isolated coarctation of the aorta. On reviewing the long term results it was found that persistence of hypertension was related to the age when the operation was performed. Dividing the patients into three age groups; group I: 0-5 years, group II: 6-15 years and group III: over 15 years, it was found that there was no late hypertension in group I while hypertension persisted in 11% in group II and 25% in group III. Fifty per cent of the patients with persistent hypertension were above the age of 20 years at the time of operation. The need for graft replacement was related to age of the patients and to the anatomy of the coarctation being used more frequently in older patients and in those where the coarctation was at the junction of the arch and the descending aorta or proximal to that site. Because of this relationship to the anatomy, the coarctations were classified into 4 types. The surgical procedures performed were: resection with end to end anastomosis, resection with replacement by a tube graft, patch and bypass grafts, in descending order of frequency. Eighty six patients have been followed up (mean 10 years). There was no hospital or late mortality (one patient committed suicide one year after operation) and none of the patients suffered from spinal cord injury. There were three recurrent coarctations in patients who had primary reconstruction under one year of age.(ABSTRACT TRUNCATED AT 250 WORDS)