Background & Objectives:�Aortic coarctation occurs in 6 to 8% of patients with congenital heart disease. It is the fourth most prevalent heart disease which requires catheterization and surgical involvement in the early years of life. If surgical repair is not conducted on-time, it can lead to heart failure (HF) and death. That is why we decided to study this disease in shahid Madani hospital, Tabriz.

Methods:�53 patients with aortic coarctation who underwent surgery from early 1999 to late 2003 in Tabriz Shahid Madani Research and Health center were studied retrospectively. 

Results: 88% of the cases were diagnosed during routine examinations. The most frequent complaints of the patients were palpitation (45%) and exertional dyspnea (41%), and the most important signs were systolic ejection murmur in 96%, weakness of lower limbs pulses in 86% and hypertension in 45%. In ECG, 96% of the patients had LVH and in CXR, 45% had cardiomegaly. In angiography, 100% of the patients had apparent aortic coarctation, which in 14 this was associated with Patent Ductus Arteriosus (PDA) In other 15 cases, PDA was not reported in angiography but was discovered during operation. The most common surgeries were resection, end-to-end anastomosis (43%) and Dacron patch angioplasty (39%). In both methods the pressure graradient decreased to under 10 mmHg in the site of anastomosis and the late complications in the patch method was more than the other one.

Conclusion:�The diagnosis of this disease had been delayed in these patients because of imprecise examination of all four limbs' pulses at the first examination of the patients, the patients' own ignorance, misdiagnosis, mismanagement and symptomatic therapy. In spite of PDA and low blood pressure in coarc region, these patients did not have severe pulmonary hypertension. Resection and end-to-end anastomosis is associated with less common late complications and if conducted in early ages, it can lead to complete recovery.

  Background & Objectives: There are several methods for PDA closure. This study compared results, complications and cost effectiveness of surgical and nonsurgical PDA closure with coil.

  Methods: Patients who admitted in Shahid Madani Hospital in 2005 surgical and nonsurgical closure of PDA were included in this study. Data were obtained from patients units. All cases followed up for six months. Data were analyzed thorough SPSS.

  Results: From 21 patients of nonsurgical method in two cases (9.5%), coil embolizations were occurred to pulmonary artery, that they were removed in cath lab and then refered to a surgery unit. One case (4.5%) has residual shunt at PDA, that who was waiting for second coil. In six month follow-up, PDA completely was closed in 18 (86%) patients and no complications were seen.

  In surgical method there were 42 patients. In six month follow-up, there were residual shunt in 2 (4.7%) cases and chylothorax in 1 (2.3%) patient, transient left diaphragmatic paresis in 2 (4.7%) and transient vocal cord paresis in 2 (4.7%) cases were seen.

  Mean at hospitalization and ICU, laboratory tests and radiographic examinations in nonsurgical method were significantly less than surgical method (P<0.0005). There was no significant difference in drug cost between two methods (P= 0.793). Mean cost of instruments and total hospital cost of the patients in nonsurgical method were significantly more than surgical method for high cost of coil (P<0.0005), but men payment of patients to the hospital in two groups did not have any significant difference (P= 0.056).

  Conclusion: In general, PDA closure through nonsurgical method had better and effective results and complications. However, it is more expensive.