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Because of the lack of information on definitive long term results of the systemic pulmonary fistulae (SPF) we decided to review our experience. From 1978/1980, SPF was carried out on 91 children with a minimal follow-up period of 53 months, 80 (88%) survive the immediate postoperative period, 65 (71%) the late period, although only 48 (53%) reached corrective surgery. 14 (50%) of the 28 newborn children died and only 9 (32%) had corrective surgery. 12 (19%) of the 63 children of two months or older died and 39 (62 por 100) had definitive surgery. 72% with Fallot syndrome, 58% with TGA and pulmonary stenosis and less than 40% of other pathologies also reached definitive corrective surgery. Frequently the SPF is the only alternative to achieve total correction although there may be a high mortality and morbidity rate. The age (newborn children) and the complex pathology are unfavourable in the end results.

Between 1978 and 1983, 35 neonates with coarctation of the aorta (from a group of 200 cases with the same pathology) underwent coarctation relief. Indications for operation were persistent heart failure and/or hypertension. Three surgical techniques were employed: Aortoplasty with prosthetic patch (politetrafluoroethylen) in 23 cases. Repair with subclavian flap in 11 cases, and resection of coarctate segment with and-to-end anastomosis in only one case. It is an important fact the high incidence of congenital cardiac malformations associated with coarctation of the aorta in neonates. There were 8 deaths (six of them with associated cardiac malformations, and other with miocardiophaty). There were 8 late deaths and 5 cases with restenosis, and no hypertension cases. All others are well in the follow-up. Some of them are waiting for definitive correction of their major cardiac malformation. The high risk of mortality in this group, mark again the importance of adequate medical treatment previous to surgical correction in optimal conditions and as early as possible.