Coarctation of the abdominal aorta.
Coarctation of the abdominal aorta remains a surgically treatable cause of hypertension in children and young adults. Average age of the patients is 21 years at the time of diagnosis and a second peak in the fourth to fifth decade. If left untreated, most patients die as a result of complications from untreated hypertension by the age of 35 years. Aortography remains the diagnostic test of choice with associated visceral and renal artery stenoses occurring in 26% of cases. Of the 146 cases reported, 109 had surgical treatment with an operative mortality rate of 6.9%. Of those patients having surgery 96% were normotensive or were easily controlled postoperatively with antihypertensive medications. Because claudication is a minor problem in most cases, surgical correction of the hypertension by hepatorenal or splenic-renal bypasses may be the preferred initial surgical treatment in patients without significant visceral artery involvement or severe symptomatic lower extremity ischemia.
Cohen
J R
JR
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Birnbaum
E
E
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D001017:Aortic Coarctation / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology; D011859:Radiography; D012077:Renal Artery / Q000601:surgery; D012078:Renal Artery Obstruction / Q000209:etiology* / Q000601:surgery; D013157:Splenic Artery / Q000601:surgery