During the decade (1950-1960), at the Los Angeles Children's Hospital, survival after the primary repair of esophageal atresia of the usual type (Gross, C; Ladd, III), in infants without other anomalies and weighing more than 3 kg. has approached 95%. A similar trend is reported from other pediatric centers throughout the world.3,10-14
At the same time (and in the same institutions), however, the mortality of all cases admitted with this anomaly (including nonoperative cases) is approximately 50%. The significant mortality in this condition is thus found in cases which are: (a) of the less common anatomical types, i.e., Types A, B, D, and E ("H") (Table 1); (b) premature, by weight; or (c) complicated by associated major anomalies. Unfortunately, these 3 groups constitute a majority (63% in the present series) of infants with this condition. Any major advance in the reduction of mortality must be directed specifically toward these