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Clinical Consideration of Coarctation of the Aorta.

Journal of the Korean Pediatric Society 1990;33(5):651-657.
Published online May 31, 1990.
Clinical Consideration of Coarctation of the Aorta.
Jong Woon Choi, Kyung Hee Park, Jung Yun Choi, Yong Soo Yoon
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
대동맥 축착에 관한 임상적 고찰*
최종운, 박경희, 최정연, 윤용수
서울대학교 의과대학 소아과학교실
Received: 28 September 1989   • Accepted: 1 November 1989
A retrospective analysis of clinical findings in 98 patients with coarctation of the aorta who visited Department of Pediatrics of Seoul National University Hospital from 1980 till 1988 was performed. 1) The most common age group was under 1 year of age (58 case; 59.2%), and male-to-female ratio was 1.58:1. 2) The common symptoms and signs were dyspnea/ tachypnea, hepatomegaly and chest wall retraction. Congestive heart failure was noted in 77.6% of cases. Turner syndrome was noted in 2 cases. 3) Femoral pulses were weak in 49.2% of cases, and absent in 3.1% of cases. The systolic blood pressure difference between upper and lower extremities was noted in 66.2% of cases. . 4) The most common electrocardiographic feature was right ventricular hypertrophy (43 cases;44. 3%). 5) On chest X-ray examination, cardiomegaly was noted in 86.3% of cases, and pulmonary vascular marking was increased in 82.1% of cases. 6) Preductal coarctations were 56 cases (57.1%) and isthmal hypoplasia was associated in 26 cases among them. Juxtaductal or postductal coarctations were 42 cases (42.9%) and isthmal hypoplasia was associated in 13 cases among them. 7) The mean systolic pressure gradient across coarctation was 24.2±19.1 mmHg (0—77 mmHg) in 56 cases. 8) Associated cardiac anomalies were patent ductus arteriosus (58 cases;59.2%), ventricular septal defect (55 cases;56.1%) and aortic stenosis (14 cases;14.3%), etc. 9) Collateral vessels were noted in 6 cases, and the mean age of them was 4 years & 10 months. 10) Associated noncardiac anomalies were cryptorchidism (2 cases), hypospadia (1 case), herma- phroditism (1 case), choledochal cyst (1 case), and pyloric stenosis (1 case), etc. 11) Corrective surgery was performed in 65 cases, and operative mortality was 18.5%. Residual stenosis was noted in 12 cases (18.5%), but reoperation was not done.
Key Words: Coarctation

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