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  • Title: Repair of coarctation of the aorta in infancy: comparison of surgical and balloon angioplasty.
    Author: Johnson MC, Canter CE, Strauss AW, Spray TL.
    Journal: Am Heart J; 1993 Feb; 125(2 Pt 1):464-8. PubMed ID: 8427142.
    Abstract:
    Surgical repair of coarctation of the aorta in infancy has recently been challenged by some investigators who suggest that balloon angioplasty results in a lower mortality rate and similar risk of restenosis. Over a 44-month period, 37 consecutive infants with a mean age of 33 days (median, 15 days; range, 1 to 200 days) and mean and median weight of 3.7 kg (range, 2.4 to 5.4 kg) underwent surgical repair of coarctation of the aorta with either an end-to-end anastomosis (24 patients) or subclavian flap angioplasty (13 patients). There were no operative deaths (95% confidence interval, 0% to 10%). Four patients died late (> 30 days) after surgery (11%). Four patients (11%) (95% confidence interval, 3% to 25%) had residual gradients greater than 20 mm Hg. A review of the recent literature on treatment of native coarctation in infants with surgical repair (18 reports, 1189 patients) and balloon angioplasty (8 reports, 57 patients) reveals a similar early mortality rate but a much higher rate of recoarctation in infants who were treated with balloon dilation (57%) as compared with those who underwent surgical repair (14%). Because of the incidence of restenosis, balloon dilation as compared with surgical repair does not yet offer an improved outcome for native coarctation of the aorta in infancy.
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