HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Winfield J. Wells Roland Hetzer Vaughn A. Starnes Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wells, W. J. Articles by Starnes, V. A. Search for Related Content PubMed PubMed Citation Articles by Wells, W. J. Articles by Starnes, V. A.

Ann Thorac Surg 1996;61:1168-1171
© 1996 The Society of Thoracic Surgeons

---

Original Article: Cardiovascular

Repair of Coarctation of the Aorta in Adults: The Fate of Systolic Hypertension

German Heart Institute, Berlin, Germany, and University of Southern California, Los Angeles, California

Accepted for publication December 6, 1995.

Background. The benefit of coarctation repair in adults has been questioned by suggesting that hypertension may not be relieved by the operation and that surgical intervention may have no impact on the natural history of the disease.

Methods. To delineate the impact of surgical intervention on systolic hypertension, we conducted a retrospective review of 26 adults with a mean age of 32 ± 10 years who underwent coarctation repair between 1987 and 1993. All patients were hypertensive (mean systolic blood pressure, 174 ± 21 mm Hg; range, 140 to 220 mm Hg), and 18 patients (69%) were on a regimen of at least one hypertensive medication at the time of surgical admission. All patients underwent catheterization, and the mean peak systolic gradient across the coarctation was 61 ± 25 mm Hg (range, 25 to 120 mm Hg). Operation included resection and end-to-end anastomosis (3 patients), resection with an interposition tube graft (6 patients), a bypass graft (11 patients), and patch angioplasty (6 patients). There was no hospital mortality or late morbidity.

Results. Intermediate follow-up was available at a mean of 2.3 ± 2 years (range, 1 to 7 years). At last follow-up, the peak systolic gradient between the upper and lower body was trivial (10 mm Hg) in 23 patients (88%) and mild (11 to 20 mm Hg) in 3 (12%). All patients had significant improvement in systolic blood pressure (p < 0.001) compared with preoperative values, and the majority (23, 88%) were normotensive. More than half of the patients (14, 54%) were still on a regimen of antihypertensive medication at last follow-up, with a trend (p = 0.06) toward older patients requiring medication.

Conclusions. Surgical repair of coarctation in adults is an effective, low-risk procedure, which results in a significant improvement in systolic hypertension and a decreased requirement of antihypertensive medications.

This article has been cited by other articles:

				K. Hashemzadeh, S. Hashemzadeh, and F. Kakaei Repair of Aortic Coarctation in Adults: the Fate of Hypertension Asian Cardiovasc Thorac Ann, February 1, 2008; 16(1): 11 - 15. [Abstract] [Full Text] [PDF]

				J. A. Carr The Results of Catheter-Based Therapy Compared With Surgical Repair of Adult Aortic Coarctation J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1101 - 1107. [Abstract] [Full Text] [PDF]

				M. E. Fawzy, M. Awad, W. Hassan, Y. Al Kadhi, M. Shoukri, and F. Fadley Long-term outcome (up to 15 years) of balloon angioplasty of discrete native coarctation of the aorta in adolescents and adults J. Am. Coll. Cardiol., March 17, 2004; 43(6): 1062 - 1067. [Abstract] [Full Text] [PDF]

				M. Bauer, V. V. Alexi-Meskishvili, U. Bauer, D. Alfaouri, P. E. Lange, and R. Hetzer Benefits of surgical repair of coarctation of the aorta in patients older than 50 years Ann. Thorac. Surg., December 1, 2001; 72(6): 2060 - 2064. [Abstract] [Full Text] [PDF]

				F. Bouchart, A. Dubar, A. Tabley, P. Y. Litzler, C. Haas-Hubscher, M. Redonnet, J. P. Bessou, and R. Soyer Coarctation of the aorta in adults: surgical results and long-term follow-up Ann. Thorac. Surg., November 1, 2000; 70(5): 1483 - 1488. [Abstract] [Full Text] [PDF]

				A. Aris, M. T. Subirana, P. Ferres, and M. Torner-Soler Repair of aortic coarctation in patients more than 50 years of age Ann. Thorac. Surg., May 1, 1999; 67(5): 1376 - 1379. [Abstract] [Full Text] [PDF]

				R. J. Morris, L. E. Samuels, and S. K. Brockman Total Simultaneous Repair of Coarctation and Intracardiac Pathology in Adult Patients Ann. Thorac. Surg., June 1, 1998; 65(6): 1698 - 1702. [Abstract] [Full Text] [PDF]

				M. Vigano, L. Ressia, R. Gaeta, and W. J. Wells Long-Term Follow-up After Repair of Coarctation of the Aorta in Adults Ann. Thorac. Surg., June 1, 1997; 63(6): 1827 - 1828. [Full Text]