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[Hypertension following repair of aortic coarctation]
M P Klerkx1, J A van Son, L K Laquet
1Afd. Kindercardiologie, Academisch Ziekenhuis Nijmegen.
Insights
Hypertension affects over 27% of patients after coarctation of the aorta repair, often linked to aortic arch hypoplasia or intracardiac anomalies. Early surgical intervention is recommended for better outcomes.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Hypertension Research
Context:
- Coarctation of the aorta is a congenital heart defect requiring surgical correction.
- Long-term outcomes, particularly hypertension, after repair are not fully understood.
- This study examines hypertension incidence and risk factors post-coarctation repair.
Purpose:
- To determine the incidence of hypertension after surgical repair of coarctation of the aorta.
- To identify correlations between hypertension and factors like recoarctation, age at surgery, surgical technique, and associated intracardiac malformations.
- To inform optimal surgical timing and management strategies.
Summary:
- A retrospective study of 65 patients who underwent coarctation of the aorta repair between 1975 and 1990 found a 27.7% incidence of hypertension.
- Hypertension was primarily associated with hypoplastic aortic arch (60%) and intracardiac anomalies (34.3%), not restenosis (only 3 cases).
- No correlation was found between hypertension and age at operation due to a small sample size for older patients.
Impact:
- Highlights the significant risk of developing hypertension post-coarctation of the aorta repair.
- Emphasizes the importance of early surgical intervention, especially in cases with hypoplastic aortic arch or complex intracardiac anomalies.
- Suggests the need for lifelong cardiovascular monitoring in patients with repaired coarctation of the aorta.
Abstract:
This article describes a retrospective investigation concerning the occurrence of hypertension in 65 patients who, between 1975 and 1990, underwent surgical repair of coarctation of the aorta. The objective of the study was to investigate the incidence of hypertension after operative correction of coarctation of the aorta. In addition an attempt was made to find a correlation between recoarctation, age at surgery, surgical technique and associated intracardiac malformations, and the presence of persistent postoperative or late occurring hypertension. Eighteen of the 65 patients (27.7%) appeared to be hypertensive 3 to 13 years (mean 5.2 years) after the operation. In only 3 patients hypertension could be explained by restenosis at the coarctation repair site. In 60% and 34.3% of the patients a correlation existed with the presence of a hypoplastic aortic arch and serious additional intracardiac anomalies, respectively. On the basis of these findings early operative treatment of coarctation of the aorta seems to be indicated, especially when the coarctation is associated with hypoplasia of the aortic arch or with complex intracardiac anomalies. Because of the relative small number of patients that underwent operative correction of coarctation of the aorta beyond the first year of life a correlation between the postoperative occurrence of hypertension and the age at operation was not found.