J Med Assoc Thai 2000; 83 (11):89

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Coarctation of the Aorta in Children at Siriraj Hospital
Laohaprasitipom D Mail, Jarucharoenpom S , Nana A , Soongswang J , Durongpisitkul K

A retrospective analysis of 33 children who were diagnosed to have coarctation of aorta at
Siriraj Hospital between January 1989 and December 1998 was undertaken. There were 21 males
(64%) and 12 females (36%). Their ages ranged from one day to 11 years (median 2 months). The
majority of the patients (78.8%) were presented early within the first year of life. The predominant
clinical manifestations were congestive heart failure (69.6% ), systemic hypertension of the upper
extremities (36.3%) and decreased femoral pulses. Chest roentgenogram revealed cardiomegaly
(70%) and increased pulmonary blood flow (84%), reflecting congestive heart failure and asso-
ciated left-to-right shunting. Electrocardiogram showed normal pattern (33.3% ), right ventricular
hypertrophy (33.3% ), left ventricular hypertrophy (22.2%) and biventricular hypertrophy ( 11.2% ).
The younger the patient is, the more right ventricular predominance is demonstrated. According to
the echocardiogram and/or aortogram, juxtaductal type was found in 51.5 per cent, postductal type
in 27.3 per cent and preductal type in 21.2 per cent. Medical management included prostaglandin
infusion in a newborn baby presented with low-cardiac output state, anticongestion and anti-
hypertension, if indicated, followed by surgical correction. The result of coarctectomy with end-
to-end anastomosis with or without arch augmentation was good. The operative mortality rate was
5 per cent. The overall mortality in the present study was 9 per cent. The most common causes of
death were multiorgan failure and pulmonary infection. Residual coarctation was found in 5 per
Key word
: Coarctation of Aorta, Children

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