Clinical Observations of Coarctation of the Aorta

Cho, Hui Jung; Han, Chang Ho; Lee, Dong Seok; Hyun, Myung Chul; Lee, Sang Bum

Abstract

PURPOSE: Due to controveries surrounding in the incidence of coarctation of aorta which reports previously stated rare among Orientals, we evaluated clinical characteristics, natural courses of coarctation of aorta and effects of different surgical modalities.
METHODS
Medical records of 51 patients with coarctation of aorta, diagnosed by 2-dimensional echocardiography in Kyungpook University Hospital Pediatric Cardiac Laboratory from June 1985 to August 1997, were retrospectively reviewed.
RESULTS
This study involved 32 male and 19 female patients(male-female ratio 1.7 : 1) aged 12 days to 11 years and 8 months(13 newborns, 32 infants and 6 children over 1 year of age). The coarctation patients consisted of 1.2% of all congenital heart disease patients diagnosed by cross-sectional echocardiography during study periods. Of the accompanying cardiac defects, patent ductus arteriosus(56.9%) and ventricular septal defect(49.0%) were the most common. Congestive heart failure was encountered in 35.3% of patients, weak or absent femoral pulse 80.4%, and higher upper limb blood pressure than lower limb 75.6%. Among the types of coarctation, juxtaductal types accounted for 30 cases(58.8%) and tubular hypoplasias 21 cases(41.2%). Preoperative Doppler gradients through the coarctation were significantly decreased(14.0+/-14.3 mmHg) after 3.7+/-3.5 years follow up. Ages at operation, follow-up periods, and residual Doppler systolic gradients through the coarctation according to different surgical methods did not show significant differences except during follow-up periods.
CONCLUSION
It is of utmost importance to palpate the pulses and check the blood pressures of upper and lower extremities in diagnosing coarctation of aorta, and there were no significant prognostic differences among different surgical methods after midterm follow-up periods.