Coarctation of the Aorta: Experience at the University College Hospital, Ibadan.

Abstract

Summary 

 Between May 1977 and June 1998, 697 patients with congenital hcart diseases were admitted to the cardiothoracic surgical unit (CTSU) at the University College Hospital, Ibadan. Eighteen (2.6 per cent) of the patients with 19 coarctations of the aorta (COA) were retrospectively studied. The age range of all the patients with CoA was 18 days to 30 years (mean 7.2–8.2 years), but for the 15 patients who underwent surgery, it was one month to 30 years (mean 8.6–8.3 years). Three patients died preoperatively of congenital cardiac anomalies associated with infantile CoA. There were 16 thoracic and two abdominal COA, while one patient had recurrent CoA. Resection and end-to-end anastomosis was performed in four patients, dacron tube interposition graft in three, and dacron patch graft in four patients. Other procedures were employed in five patients. Operative mortality was 25 per cent. Operative deaths occurred in two infants with isolated COA, a neonate who had associated pulmonary hypertension and a 17-year old who had surgery for re-coarctation. Complications of surgery included post operative haemorrhage in two patients, intra-operative hemorrhage in one and hoarseness of the voice in four patients. Paradoxical hypertension occurred in three patients, graft occlusion and wound dehiscence occurred together in one patient and two patients had chylothorax. It is concluded that CoA is a surgically correctable congenital anomaly which is probably less frequently diagnosed locally.