• Diagnostic and prognostic factors were studied in 30 cases of coarctation of the aorta in which either surgery or autopsy was performed within the first year of the patient's life. Two important considerations were the patency of the ductus arteriosus and the location of the coarctation, whether proximal or distal to the ductus arteriosus. The largest group of patients consisted of 11 infants with a patent ductus and the coarctation proximal to the ductus (type 2A). In this situation there is little stimulus to the development of collateral circulation. Two infants in this group were saved by surgical intervention; the other nine died. The best prognosis was in type 1B, represented by eight infants in whom the coarctation was distal to a patent ductus arteriosus; five of these were saved by surgical intervention. Exact diagnosis is important in deciding whether surgery is likely to prove lifesaving in these conditions. The physical examination must include observation of the distribution of cyanosis over the body, inequalities of blood pressure in the extremities, and especially thorough roentgenographic study, which is essential.
Lester RG, Margulis AR, Nice CM. ROENTGENOGRAPHIC EVALUATION OF COARCTATION OF THE AORTA IN INFANTS. JAMA. 1957;163(12):1022–1026. doi:10.1001/jama.1957.02970470020005
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