[Optimal age for the surgical treatment of aortic coarctation. Statistical study on long-term blood pressure values]. / Age optimum pour le traitement chirurgical de la coarctation de l'aorte. Etude statistique sur les chiffres tensionnels à long terme.

UNLABELLED: A retrospective statistical study on late blood pressure in patients operated for coarctation of the aorta have been done, in order to determine the optimum age for elective surgical treatment. Patients were considered hypertensive when their mean blood pressure exceeded the 90th percentile for their age and sex. The series included 126 isolated coarctation of the aortic isthmus operated at the CMC of the Porte de Choisy. The incidence of residual hypertension at rest in the series is as follows: age 1-5: 16,6 %;age 6-10: 34,3%; age 11-15: 47,5 %. In spite of these results there is no significative difference in the incidence by age group. A similar study by the Massachusetts General Hospital on 77 patients showed essentially the same results. A combination of both series (203 patients) which is possible because the study criteria are the same, gives the following results: age 1-5: 11,4 %;age 6-10: 31,9 %; age 11-20: 40,8 %. There is now a significative difference between age group 1-5 and the others (p Less Than 0,02). IN CONCLUSION: the optimum age for elective correction of coarctation of the aorta is 1-5 year. The incidence of residual hypertension is only 11,4 % in that group (70 % confidence limits: 6 to 20%).

[Veinous return from the inferior vena cava into the left atrium after surgical correction of Fallot's tetralogy]. / Retour veineux cave inférieure dans l'oreillette gauche après correction d'une tétralogie de Fallot.

A child of 6 presented with a syndrome of gross respiratory distress together with persistant arterial desaturation, requiring ventilation for maintenance of life, occurring after the apparently straightforward correction of a Fallot's tetralogy. Postoperative investigation on the 15th day showed the reasons for the desaturation: there was a massive right-left shunt caused by flow from the inferior vena cava into the auricle of the left atrium through a low atrial septal defect which had not been recognised. Reoperation on the 15th day to close the atrial septal defect corrected the condition satisfactorily.