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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2011 December;52(6):873-6
Hypertension in adult after operation of aortic coarctation
Palma G., Giordano R., Russolillo V., Cioffi S., Palumbo S., Mucerino M., Poli V., Vosa C. ✉
Department of Clinical Medicine and Cardiovascular Sciences, University of Naples Federico II, Naples, Italy, Adult and Pediatric Cardiac Surgery University of Naples Federico II, Naples, Italy
AIM: The benefit of coarctation repair on the resolution of systolic hypertension in adults has been questioned.
METHODS:Between March 1997 and July 2009, 65 consecutive adult patients (≥16 years) underwent repair of aortic coarctation. There were 40 men (65%) and 25 women (35%) with a mean age of 22.3±4.8 years (range, 16 to 34 years). All patients had critical systolic blood hypertension (SBP ≥140 mmHg). SBP ranged from 140 to 205 mmHg, with a mean of 163.5±17.6 mmHg. The mean diastolic BP was 95.1±18.3 mmHg (range, 70 to 120 mmHg). Most patients (41/65, 74%) were on a regimen of at least one antihypertensive drug.
RESULTS:The patients were followed up after coarctation repair for 2 to 144 months (mean, 68 ± 39 months). There was no death. No other major complications occurred. There have been no repeat interventions during follow-up. Four patients were lost to follow-up. Of the 61 patients with preoperative hypertension, 53 (87%) were normotensive (SBP <140 mmHg) at the most recent follow-up visit. The remaining eight patients showed substantial improvement versus the preoperative status. The mean SBP after operation was 122.5±12.4 mmHg. Mean diastolic blood pressure was 79.5±11.6 mmHg. Forty-one (67%) patients were taking no medication at the last follow-up.
CONCLUSION: Surgical repair of coarctation of the aorta in adults can lead to regression of systolic hypertension and a decreased requirement for antihypertensive medication.