Document Detail


Surgical treatment of aortic coarctation in adults: Beneficial effect on arterial hypertension.
MedLine Citation:
PMID:  19039758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to determine the outcome after surgical repair of aortic coarctation in adults, analysing its effect on arterial blood pressure. METHODS: Twenty-five adults (9 women, 16 men), mean age 43.4 years (19 to 70 years), underwent aortic coarctation surgical repair. All patients suffered from preoperative hypertension. Mean blood pressure was 182/97 mm Hg. Sixteen (64%) patients demonstrated reduced load capacity. Operative technique was resection and end-to-end anastomosis for 5 patients (20%), interposition of a Dacron-tube graft for 3 patients (12%), Dacron-patch dilatation was performed in 7 (28%) patients, and in 10 (40%) patients we performed an extra-anatomical bypass graft. RESULTS: Early mortality occurred in 1 patient (4%). The mean blood pressure was reduced [systolic 182 mm Hg vs. 139 mm Hg (p < 0.001), diastolic 97 mm Hg vs. 83 mm Hg (p < 0.001)] in all patients. In 12 patients, blood pressure normalized immediately after surgery, in 7 patients it remained slightly elevated (systolic blood pressure between 140-160 mm Hg), and 1 patient suffered from prolonged arterial hypertension. Preoperatively, all patients were treated with antihypertensive drugs. Eleven of 20 patients received long-term medication during follow- up. In the remaining 4 patients, medication lists were unobtainable in retrospect. The mean follow-up was 7.1 years (min. 1.0 years; max. 16.6 years). One patient (5%) died from cardiac failure 12.4 years after the operation. On average, the New York Heart Association (NYHA) class was improved by 0.92. CONCLUSIONS: The surgical repair of aortic coarctation in adults can be performed with low surgical risk. Surgery reduces hypertension and permits more effective medical treatment.
Authors:
Włodzimierz Kuroczyński; Marc Hartert; Diethard Pruefer; Katrin Pitzer-Hartert; Markus Heinemann; Christian-Friedrich Vahl
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  15     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-28     Completed Date:  2009-04-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  537-42     Citation Subset:  IM    
Affiliation:
University Hospital Mainz, Department of Cardiothoracic and Vascular Surgery, Johannes-Gutenberg-University, Mainz, Germany. kuroczynski@uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Coarctation / complications,  mortality,  surgery*
Blood Pressure / physiology*
Blood Vessel Prosthesis
Female
Follow-Up Studies
Germany / epidemiology
Humans
Hypertension / complications*,  physiopathology
Male
Middle Aged
Retrospective Studies
Survival Rate / trends
Treatment Outcome
Vascular Surgical Procedures / methods*
Young Adult
Comments/Corrections
Comment In:
Cardiol J. 2008;15(6):491-2   [PMID:  19039751 ]

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


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