تکنیک های مختلف جراحی کوارکتاسیون آئورت و موارد عمل شده آن در بیمارستان دکتر شریعتی

This study is on different surgical techniques for repair of Co-arctation of aort and their effect for correction of systemic hypertension and lower extremity hypotension. In addition to these, the clinical and paraclinical data were noticed. 50 pt were operated in "SHARIATI" hospital during 1370-1377 with diagnosis of Co-arctation of aorta (30 men, mean age 19.4 years, 20 women, mean age 16.6 years). In addition to older age of our patients which results in more post-op sequela, there was suprrisingly a long-lag between onset of symptoms, diagnosis and operation (mean 4.36 years). 62% of Co-arctation were juxtaductal and the remainder were non-classical forms. 52% of our patients had co-existing cardiac disease which were very high in comparison with other studies (12%). This is due to older age of our patients and more valvular heart diseases. Among complicated cases of co-arctation, 71.9% were in men and 28.1% in women and this difference is due to high incidence of bicuspid aortic valve in men. The mean angiographic gradient were 57.5 mmHg which increases with age. CXR was abnormal in 91.7% and ECG in 74.2% of patients. The different applied surgical techniques include ee-A=26%, TIG=40%, TBG=18%, DPR=14%, FSCR=2%. There is no significant difference regarding post-op complications, BP in post-op period, and increase in pedal pulses, except in TBG group which HTN was more common. Two early deaths occurred which were in DRP group.