Impaired elastic properties of the ascending aorta persist within the first 3 years after neonatal coarctation repair.
Abnormal elastic properties of the ascending aorta in patients with coarctation of the aorta (CoA) are already present in neonates before and after successful repair. To prove the midterm outcome for vascular pathology, a cohort of 15 patients was prospectively reevaluated. In this study, 15 patients after neonatal CoA repair (study group) and 15 healthy normal children (control group) were examined (mean age, 3.0 +/- 1.0 years). The aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic M-mode diameters and noninvasive estimation of pulse pressure. The study group was compared with the control group and with its own previously obtained pre- and postoperative measurements. After a mean follow-up period of 2.9 +/- 0.9 years, the elastic properties of the ascending aorta remained impaired in the study group compared with the control group (distensibility: 62 +/- 28 vs 94 +/- 34; p = 0.01; stiffness index: 4.4 +/- 1.9 vs 2.7 +/- 1.0; p = 0.008). At follow-up evaluation, the elasticity of the ascending aorta in the study group showed no change from the initial neonatal findings (distensibility: 63 +/- 24 vs 62 +/- 28; p = 0.82; stiffness index: 4.0 +/- 1.6 vs 4.4 +/- 1.9; p = 0.65). In both groups, descending aortic elasticity increased during the follow-up period. Our data suggest that the diminished elastic properties of the prestenotic arteries remain unchanged years after successful CoA repair. Comparisons with the neonatal data showed no evidence for remodeling of the ascending aorta in this group.
Kühn
Andreas
A
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Lazarettstrasse 36, 80636 München, Germany.
Baumgartner
Daniela
D
Baumgartner
Christian
C
Hörer
Jürgen
J
Schreiber
Christian
C
Hess
John
J
Vogt
Manfred
M
D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001013:Aorta, Thoracic; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002675:Child, Preschool; D004452:Echocardiography; D004548:Elasticity; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014655:Vascular Resistance