Surgical correction of aortic coarctation in children.

tion of the heart, and particularly of the right ventricle, when the heart is in its correct central position. If during intra-uterine life the heart is not central and during development lies to the left side, leaving the mediastinum empty, there will be no positive force to elevate the sternum, but rather a negative pressure which will suck it in. The ribs and sternum ossify early, but the costal cartilages and costochondral joints remain mobile and supple until late adolescence. If during this period of growth the heart is not central, the sternum will be sucked in during each inspiration, and overgrowth of the costal cartilages will take place to fill the empty mediastinum. The operation consists of excising the deformed cartilages and suturing the heart into its central position, thus correcting the deformity.