57 infants and small children (42 boys and 15 girls) with congenital aortic malformations were investigated. Clinical, ecg and X-ray follow-up was carried out. Following 4 groups of patients were separated: 1) neonates and infants with supraductal (preductal) aortic hypoplasia or atresia, with hypoplastic left ventricle of the heart (5 boys and 2 girls), 2) infants with supraductal coarctation of the aorta, without underdevelopment of the left heart cavities (2 boys and 2 girls), 3) infants and children with postductal coarctation of the aorta (17 boys and 3 girls) and 4) infants and children with valvular or/and subvalvular, or supravalvular aortic stenosis (18 boys and 8 girls).

Conclusions: Congenital malformations of the aorta and of the left side of the heart should be suspected in all neonates and infants displaying early symptoms of cardiorespiratory failure, resembling frequently the symptoms of severe "pneumonia". Proper measurement and thorough analysis of arterial pulses and pressures in upper and lower extremities is of great importance in detection and differential diagnosis of congenital aortic malformations in infants, even when features of other cardiovascular lesions (e.g. ventricular septal defect, endocardial cushion defect, transposition of the great arteries) dominated in the clinical picture of complex malformations. Small amplitudes of peripheral arterial pulses, with considerably--prolonged upstroke time, small amplitude of arterial pressure measured in upper and lower extremities, co-existing with electrocardiographic patterns of the right ventricular hypertrophy--suggested an aortic malformation complicated by hypoplasia of the left ventricle. Distinctly lower systolic and mean arterial pressure in legs, than in arms was typical for coarctation of the aorta. Significant differences in diastolic pressure values in arms and legs with coexisting ecg patterns of dominating right ventricular hypertrophy should rise a suspicion of abnormal, separate communication of the ascending aorta, and the descending aorta, separately from the left and from the right ventricles of the heart. The electrocardiogram seems to be of great help in differentiation between aortic lesions with or without hypoplastic left ventricle, those with or without systemic right and left ventricle, and those with systemic left ventricle only. Early detection, diagnosis, prompt and proper medical and surgical treatment may be lifesaving for the majority of infants with congenital malformations of the aorta not complicated by left ventricular hypoplasia.