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Coarctation of the aorta corrected during the first month of life.

Killingbeck Hospital, Leeds.

Forty eight children (29 boys) had surgical correction of coarctation of the aorta during the first month of life; all had patent ductus arteriosus. The 33 survivors were reviewed at a mean age of 6.6 years. Of the 19 children with no associated anomaly, none had died. The more complex the associated anomalies, the greater the mortality. Two (6%) of the survivors, both with associated anomalies, have some residual disability; one is incapable of leading an independent life. No survivor has systemic hypertension. Six (18%) of the survivors have required correction of recurrent coarctation, and one is awaiting repair. Newborn babies suspected of having coarctation should be assessed for surgical correction without delay, and medical treatment (including, if necessary, infusion of prostaglandin E2 in a dose of 0.025 micrograms/kg/minute) should be instituted in the interim. Long term follow up is important to detect systemic hypertension or recurrence of the coarctation. This occurred in seven (21%) of our survivors.