The association of intracardiac lesions with coarctation of the aorta (CoAo) is a situation that could be repaired in only one surgery by anterior midline approach, despite of sugestión of increased risk if compared with two stage repair. Our experience with this approach is a group of 22 children, with ages ranging from 12d to 18y (48.9m), being 12 male, from Jun 88 to Dec 92. All children had CoAo associated whith different intracardiac lesions like VSD in 12 (isolated in 6; with mitral and subaortic stenosis in 3; with subaortic stenosis in 2 and 1 with mitral regurgitation); aortic and subaortic stenosis in 5, mitral stenosis in 2. All children were operated on by anterior midline approach using cardiopulmonary bypass and profound hypothermia to repair first the CoAo and after the intracardiac lesion. In 17 children the CoAo zone was excised with end to end anastomosis; in 4 the left subclavian flap was used and in 1 a Dacron graft was used. No deaths were observed and the main immediate complications were low cardiac output syndrome in 3 and pneumonia in 2 children. In a follow up period from 1 to 50m (17.7%), 16 children are well and assymptomatic and 4 have incaracteristic chest pain. In the same period, the CoAo repair was evaluated by ECHO with no residual stenosis. In conclusion, the concomitant repair showed good results with low morbidity and no mortality in children with different ages and diagnosis.
intracardiac surgical lesions; aortic coarctation