Objectives. We compared outcomes in infants undergoing end-to-end anastomosis (EEA) or subclavian flap repair (SFR) for aortic coarctation in a single centre.

Methods. This was a retrospective study of 177 consecutive infants undergoing aortic coarctation repair between December 1995 and January 2008. Infants with associated complex cardiac defects or undergoing concomitant cardiopulmonary bypass were excluded.

Results. Ninety-seven infants underwent EEA and 80 infants SFR with non-significant differences in median ages and weights. Median hospital stay was 8 (4-56) and 10 (4-188) days in the EEA and SFR groups respectively (p=0.37). One hospital death occurred in each group (1.1%) and was due to non-cardiac pathology. Mean follow-up for all patients was 6.3±3.3 years. Post-operative morbidity occurred in 14.3% of the EEA and 7.5% of the SFR group (p=0.17).
Five-year survival was 97% (CI 86.7%-99.2%) in those undergoing EEA and 98.3% (CI 88.7%-99.7%) in patients with SFR (p=0.5). Cardiac event-free survival (catheter intervention for restenosis) including death at 5 years was 89.9% (CI 80%-94.9%) and 92.2% (CI 83.4%-96.4%) in the EEA and SFR group respectively (p=0.4).
At latest follow-up, mean echocardiographic descending aortic Doppler velocities were 1.9±0.5 m/s and 2.0±0.6 m/s in the EEA and SFR group respectively (p=0.7). Medically treated systemic hypertension was present in 12.3% of EEA and 15% of SFR patients (p=0.4).

Conclusions. Both techniques achieve excellent comparable early and longer term outcomes in infants undergoing aortic coarctation repair. With negligible mortality, continued evaluation of surgical technique on relevant major pathology (re-intervention and hypertension) in later life is warranted.