title: Repair of aortic coarctation in adults: the fate of hypertension.
abstract: The benefit of coarctation repair on the resolution of systolic hypertension in adults has been questioned. In this retrospective study, hypertension was assessed in 38 adults (22 men, 16 women; mean age, 25.6 +/- 6.9 years; range, 16-39 years) who underwent coarctation repair between 1996 and 2006. Thirty patients had preoperative hypertension (mean systolic pressure, 158.3+/-18.6; range 140-200 mm Hg). At preoperative catheterization, the peak mean systolic gradient across the coarctation was 70.6 +/- 21.2 mm Hg (range, 38-120 mm Hg). Operative procedures were resection and end-to-end anastomosis (11 patients), patch aortoplasty (24) and resection with interposition of a Dacron tube graft (3). The patients were followed up for 2-90 months (mean, 37 +/- 23 months). Of the 30 patients with preoperative hypertension, 25 (83%) were normotensive at the last follow-up. The mean postoperative systolic blood pressure was significantly lower than the preoperative level. More than half of the patients (58%) were still taking antihypertensive medication. Surgical repair of coarctation of the aorta in adults can lead to regression of systolic hypertension and a decreased requirement for antihypertensive medication.
authors.affiliation: Department of Cardiovascular Surgery, Shahid Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Khosro
authors.initials: K
authors.lastname: Hashemzadeh
authors.forename: Shahriar
authors.initials: S
authors.lastname: Hashemzadeh
authors.forename: Farzad
authors.initials: F
authors.lastname: Kakaei
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001017:Aortic Coarctation / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000187:drug effects*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007492:Iran; D008297:Male; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D012189:Retrospective Studies; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation
chemical_list: D000959:Antihypertensive Agents; D011093:Polyethylene Terephthalates