Role of surgical correction of aortic coarctation on hypertension in adults

ABSTRACT

To diagnose the impact of surgical intervention on systolic hypertension, a retrospective study reviewed 14 adults with a mean age of 27.3 +/- 6.2 years who underwent coarctation repair at Al-Azhar University Hospital between 1995 and 2002. All patients were hypertensive [mean systolic blood pressure 169.3 +/- 21.4 mmHg, range 140 to 220 mmHg] and 9 patients [64.2%] were on a regimen of at least one hypertensive medication at the time of surgical interference. All patients underwent cardiac catheterization and the mean peak systolic gradient across the coarctation was 57.9 +/- 24.4 mmHg [range 25 to 120 mmHg]. Operative procedures included resection of the coarctation segment with an interposition of tube graft [3 patients], resection and end-to-end anastomosis [2 patients], a bypass graft [6 patients] and patch angioplasty [3 patients]. There was no hospital mortality or late morbidity. Early and intermediate follow up was available at a mean of 2.5 +/- 2 years [range 1 to 6 years]. At last follow-up, the peak systolic gradient between the upper and lower body was trivial. All patients had significant improvement in systolic blood pressure compared with preoperative values, specially older patients requiring medication