Correction of aortic coarctation in newborns and infants

Objective. To analyze the results of correction of aortic coarctation in newborns and infants. Material and methods. There were 249 surgical interventions for aortic coarctation in newborns and infants between 2008 and 2023. All patients were divided into 2 groups depending on surgical technique: group 1 — end-to-end anastomosis (n=135), group 2 — extended end-to-end anastomosis (n=114). Both groups were comparable in clinical and demographic indicators (median body weight 5.9 kg (range 1.7—15.2 kg) with body surface area 0.34 m2 (range 0.13—0.41 m2). Median age before surgery was 89 days (range 1—341). Results. There was no intraoperative mortality. Early postoperative mortality was 1.2% (3 patients). We studied 239 (97.1%) cases in long-term period. Mean follow-up was 10.2 years (range 8—14 years). Aortic recoarctation was observed in 19 (7.8%) patients (9 (6.7%) and 10 (9.2%) patients, respectively, p=0.12). Predictors of recoarctation in long-term period were low body weight before surgery (≤2900g) (OR 8.2; p=0.013) and aortic arch hypoplasia (OR 17.1; p=0.025). Conclusion. End-to-end anastomosis and extended anastomosis are effective for aortic coarctation in newborns and infants good postoperative and long-term outcomes. However, low body weight and aortic arch hypoplasia increase the risk of redo surgery.