OBJECTIVE: To employ a flexible approach for repairing @entity1498 in an attempt to minimize @entity41 and avoid the use of synthetic material. DESIGN: Retrospective study of consecutive @entity1 undergoing surgical repair of @entity1498 . SETTING: Walter C Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta. @entity1 : @entity1 presenting with @entity1498 between June 1993 and October 1996 (n = 42), treated by one surgeon. INTERVENTIONS: @entity1 had repair by one of three methods: subclavian flap angioplasty for discrete @entity1498 , 17 (40%); resection and end-to-end @entity254 , 13 (31%); and resection with extended transverse arch repair, 12 (29%). MAIN RESULTS: Follow-up was 22 +/- 2 months. The preoperative mean arm-leg gradient was 23 +/- 3 mmHg and postoperatively was 4 +/- 2 mmHg (P < 0.001). In late follow-up, five @entity1 developed a significant gradient (end-to-end @entity254 , one; transverse arch repair, two; subclavian flap angioplasty, two) necessitating @entity384 , one of whom (subclavian flap angioplasty) eventually required end-to-end repair. Another @entity1 , who had a subclavian flap angioplasty, underwent transverse arch repair at the time of complete cardiac repair. There was one perioperative @entity204 in a @entity1 who was in extremis preoperatively and three late deaths in @entity1 with additional @entity154 . CONCLUSIONS: A flexible surgical approach with avoidance of synthetic material and low threshold for extended repair has yielded good early and intermediate term results.

XXXX : tailoring the surgical approach.

@entity1 :: ('9606', 'Species') :: ['children', 'Children', 'PATIENTS', 'child'] @entity154 :: ('MESH:D000013', 'Disease') :: ['complex intracardiac anomalies'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual coarctation'] @entity384 :: ('MESH:D002311', 'Disease') :: ['balloon dilation'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity1498 :: ('MESH:D001017', 'Disease') :: ['coarctation of the aorta', 'juxtaductal coarctation'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity1498 :: (MESH:D001017,Disease) :: ['Coarctation of the aorta']
