During the 10-year period 1962 - 1971, coarctation of the aorta was diagnosed within the first 5 months of life in 35 hospital cases. Of these, 29 (83%) were symptomatic, and 18 (54%) underwent surgery to correct the coarctation. Thirteen of the 18 patients (72%) survived the procedure. Of the 5 patients who died, 2 had single-ventricle complexes, and 1 had an associated ventricular septal defect and died at a subsequent operation for pulmonary artery banding. One patient who survived had a thoracotomy with no procedure done to the aorta. All survivors were followed up for at least 1 year. Residual gradients were found in 6 of the 12 patients (50%), but classified as severe in only 2 cases. Of the 11 patients who were symptomatic but who did not undergo surgery, 7 died (mortality 63%). There were 6 remaining patients who were asymptomatic. There have been 3 deaths in this series-all unrelated to their cardiac pathology. It is strongly recommended that young babies with coarctation of the aorta, who develop congestive cardiac failure, undergo 36 - 48 hours of medical therapy, after which surgical resection of the coiucted segment is carried out. This approach offers the best prospects for survival.S. Afr. Med. J., 48, 397 (1974
