The benefit of bypass versus interposition graft in the surgical treatment of coarctation of aorta in Iraq

Abstract EN

A total no.

of 48 cases of coarctation of aorta with average age of 13 years and age range from 4 to 32 years, during the period (1998 to 2005), 56 % of them underwent interposition surgery for the coarct segment ,either interposition graft or resection ; manipulation and reapproximation.

those patients represent the first group.

The second group represents 44 %, sustained bypass graft from the junction of subclavian artery with the aorta to the distal point beyond the coarct segment.

The influence of 24 preoperative, intraoperative and postoperative characteristics on operative mortality risk was investigated utilizing stepwise logistic regression analysis.

The overall operative mortality was two death both in the first group only with no mortality in the second group.

The use of first group surgical approach, long aortic clamping time (which is consistent with the first group) and high left ventricular mass index ; all were a strong predictors of operative mortality .operative morbidities ( which includes spinal cord insult, sustained postoperative hypertention, cerebrovascular accident ), regarding spinal cord insult and sustained cerebrovascular accident both of them reported in one case while postoperative sustained hypertention was reported in 14.6% of patients most of them in first group.

Thus, the early results of coractation of aorta surgery can be related to several specific variables describing the surgical approaches of the patients.

This information should provide for a more rational approach to this surgical procedure, at least in terms of early risk / benefit deliberations and the surgeon must identify the factors that predict postoperative mortality and mortality to develop alternative strategies for high risk patients.