Document Detail

Surgical approach for aortic coarctation influences arterial compliance and blood pressure control.
MedLine Citation:
PMID:  20667357     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increased arterial stiffness is linked to hypertension in adults after surgical repair for coarctation of the aorta. We evaluated the influence of surgical approaches, namely, subclavian flap repair (SFR) and end-to-end anastomosis (EEA), on arterial stiffness, blood pressure, cardiac output, and cardiac baroreceptor function in a cohort of young children after coarctation repair to determine if the surgical approach influenced longer term blood pressure control. METHODS: We measured pulse wave velocity in 21 children with a mean age of 5 years, after early (less than 6 months) coarctation repair (SFR, n = 11; EEA, n = 10), and compared these with 18 matched controls. Blood pressure was recorded on three occasions from the right arm. Cardiac output was recorded using a transthoracic bioimpedence technique. We measured spontaneous baroreceptor reflex sensitivity to evaluate whether increased arterial stiffness was associated with reduced aortic baroreflex sensitivity. RESULTS: Right arm systolic blood pressure (108.3 + or - 3.5 mm Hg SFR versus 97.8 + or - 2.9 mm Hg EEA, p = 0.03) and pulse wave velocity (6.0 + or - 0.2 ms(-1) SFR versus 5.2 + or - 0.2 ms(-1) EEA, p = 0.02) were significantly greater in the SFR compared with EEA group. Blood pressure and pulse wave velocity were also higher in the SFR group compared with controls. These differences were not demonstrated when comparing the EEA group with controls. There was no difference in stroke volume, spontaneous baroreceptor reflex sensitivity, or heart rate or blood pressure variability between the groups. CONCLUSIONS: Young children undergoing SFR have higher blood pressure and stiffer upper limb arteries compared with matched children undergoing EEA. Our data suggest that better longer-term cardiovascular outcome is to be expected with the EEA surgical approach.
Damien Kenny; Jaimie W Polson; Robin P Martin; Dirk G Wilson; Massimo Caputo; John R Cockcroft; Julian F R Paton; Andrew R Wolf
Related Documents :
3595097 - Total systemic arterial compliance and aortic characteristic impedance in the dog as a ...
14714577 - The relationship between pulse wave velocity and pulse pressure in chinese patients wit...
3129207 - Effect of nitroglycerin on aortic impedance, diameter, and pulse-wave velocity.
3976477 - The electrocardiogram at extreme altitude: experience on mt. everest.
599107 - The role of feedback in voluntary control of blood pressure in instructed subjects.
22935727 - Use of the isopycnic plots in designing operations of supercritical fluid chromatograph...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  600-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Bristol Congenital Heart Centre, Bristol Royal Hospital for Children, Bristol, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anastomosis, Surgical
Aortic Coarctation / physiopathology,  surgery*
Arteries / physiopathology
Blood Pressure
Cardiac Surgical Procedures / methods
Child, Preschool
Retrospective Studies
Subclavian Artery / surgery
Surgical Flaps

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Regional high-flow cerebral perfusion improves both cerebral and somatic tissue oxygenation in aorti...
Next Document:  Cardiac Operations After Patent Ductus Arteriosus Stenting in Duct-Dependent Pulmonary Circulation.