Coarctation Long-term Assessment (COALA): Significance of arterial hypertension in a cohort of 404 patients up to 27 years after surgical repair of isolated coarctation of the aorta, even in the absence of restenosis and prosthetic material

Hager, Alfred; Kanz, Simone; Kaemmerer, Harald; Schreiber, Christian; Hess, John

doi:10.1016/j.jtcvs.2007.04.027

Cited by 274 publications

(185 citation statements)

References 34 publications

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“…In addition to HBP, complications such as neurological or motor disturbances were observed [24]; in our experience no patient presented neurological complications. Lisboa et al [11] also reported the absence of neurological complications with extra-anatomical techniques.…”

Section: Discussionmentioning

confidence: 44%

“…As observed by Hager et al [24], in a study involving 404 patients followed-up in a period from 1 to 27 years, the majority of the patients remained hypertensive in the long-term, whereas only a minority of the cases presented gradients higher than 20 mmHg and 43% of the patients undergone surgical correction of the aortic coarctation presented blood pressure stabilization. Unlike some reports, in our study, more than 90% of patients presented blood pressure stabilization in the postoperative evolution period, with or without the use of medication.…”

Section: Discussionmentioning

confidence: 68%

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Resultados do tratamento cirúrgico da coarctação de aorta em adultos

Jatene¹,

Abuchaim²,

Oliveira³

et al. 2009

Rev Bras Cir Cardiovasc

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Objective: The aim of this study is to describe our experience in aortic coarctation surgery in adult patients by assessing the immediate and mid-term outcomes.Methods: From January 1997 to March 2000, 50 consecutive adult patients underwent surgery for correction of aortic coarctation, through left lateral thoracotomy. Of these, forty two (84%) patients presented high blood pressure, with mean systolic arterial pressure of 170.56 mmHg (125-220 mmHg). The mean of pressure gradient in the coarctation area was 51.4 mmHg (18-123 mmHg). Other associated surgical cardiovascular diseases were not treated in the same operative act, except in two cases of patent ductus arteriosus (PDA). Three different techniques were used: aortic coarctation resection with end-to-end anastomosis was performed in 20 (40%) patients, coarctation enlargement with bovine pericardial patch was performed in 22 (44%) patients and synthetic tube interposition was performed in eight (16%) patients.Results: Operative morbidity was low; there was one case of bleeding who required reoperation. The most common immediate postoperative event was high blood pressure (98%), but it was easily controlled by intravenous drugs. There was no hospital death. Mean residual pressure gradient was 18.7 (8-33 mmHg). Patients were discharged in 9.5 days (5-30). Postoperative follow-up mean was 46.8 months (1-145 months) in 45 (91.8%) patients. Forty one (91.1%) of these followed-up patients had normal blood pressure, whereas 75.6% of them without drugs intake. 93.3% of these followed-up patients were asymptomatic. Four of them required further surgical operation, one needed a pacemaker implant, other two patients needed a cardiac valve replacement and one had endocarditis. There was one related death due to sepsis secondary to endocarditis.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 68%

Resultados do tratamento cirúrgico da coarctação de aorta em adultos

Jatene¹,

Abuchaim²,

Oliveira³

et al. 2009

Rev Bras Cir Cardiovasc

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show abstract

“…[40]. However, in a small crossover study of 18 adult patients, metoprolol was found to be more effective than candesartan at lowering systolic blood pressure [10]. …”

Section: Discussionmentioning

confidence: 97%

“…This suggests that HTN may be an inevitable consequence of CoA, even when an effective anatomical repair has been achieved early in life [8,10,28]. Although it is unclear why this may be the case, it is postulated that there is dysfunction of the normal control mechanisms regulating BP during growth and development in patients with repaired CoA [8,10]. As HTN is present as a symport in nearby all cases of CoA, the preoperative treatment can be effectively achieved by the using beta-blockers.…”

Section: Discussionmentioning

confidence: 99%

Late Coarctation Presenters Suffer Chronic Hypertension Resisting to Medicine Treatment

Petropoulos

2017

Open J Pediatr Child Health

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Coarctation of the aorta (CoA) is a common Congenital Heart Disease (CHD) presenting with many symptoms and signs, in any age group. From its dramatic appearance as a part of Hypo plastic Left Heart Syndrome(HLHS), to early Congestive Heart Failure(CHF)in neonatal and early infantile age, to undetected Hypertension (HTN) in early or even late adulthood. The aim of this short review is to present this unique CHD, underline the presentation of late detected CoA, presenting with HTN and its impact in treating resistant HTN even after successful surgical treatment. Finally, the late onset HTN, following successful surgical treatment and its medicine management will be addressed. This diffi cult to control on mono or dual pharmacotherapy and the late complications of persistent uncontrolled HTN is the basic reason that these patients are a long-life follow-up population with important medical needs and increasing morbidity and mortality.

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“…По результатам обследования отмечено повышенное артериальное давление у 22 из 44 пациентов с готи-ческой формой, у 5 из 18 с прямоугольной и у 2 из 43 с нормальной формой дуги аорты. Однако многие авторы [2,3,8] видят причину резидуальной гипер-тензии в изменении коллагеноэластинового каркаса в аорте или в аномальной функции барорецепторов, которые увеличивают периферическое сосудистое сопротивление [6,7].…”

Section: результаты и обсуждениеunclassified

Surgical treatment of aortic arch malformations in infants under cardiopulmonary bypass

IuN

IuS

et al. 2015

Khir. Z. im. N.I. Pirogova

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ВведениеОбструкция дуги аорты или ее перерыв часто требует неотложного хирургического вмешатель-ства в неонатальном периоде [1]. Хотя результаты реконструктивных операций на дуге аорты были значительно улучшены, отдаленные результаты до сих пор нельзя назвать вполне удовлетворительны-ми. Есть достаточно данных, свидетельствующих о том, что у 16-28% пациентов даже при отсутствии анатомической обструкции в отдаленные сроки со-храняются артериальная гипертензия и системная сосудистая дисфункция [5,11]. Как правило, такие пациенты имеют структурные, функциональные и Results. Follow-up was 42±14 months. In the long-term recoarctation occurred in 7 (13.7%) cases including 6 (18.75%) patients in group 1 and one (3.3%) patient in group 2. Residual hypertension was observed in 12 (23.5%) cases including 10 (37%) patients in group 1 and 2 (8.3%) patients in group 2. Six (50%) patients receive antihypertensive therapy, 5 (41.6%) patients who receive antihypertensive drugs have persistent increase of blood pressure without evidence of anatomic aortic obstruction. Hypertensive response to functional tests was observed in one patient.Conclusions. Aortic arch reconstruction using autoplasty is associated with lower risk of recoarctationand residual hypertension compared with xenopericardial patch application.Keywords: obstructive pathology of the aortic arch, surgical treatment, cardiopulmonary bypass. © Коллектив авторов, 2015

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Coarctation Long-term Assessment (COALA): Significance of arterial hypertension in a cohort of 404 patients up to 27 years after surgical repair of isolated coarctation of the aorta, even in the absence of restenosis and prosthetic material

Cited by 274 publications

References 34 publications

Resultados do tratamento cirúrgico da coarctação de aorta em adultos

Resultados do tratamento cirúrgico da coarctação de aorta em adultos

Late Coarctation Presenters Suffer Chronic Hypertension Resisting to Medicine Treatment

Surgical treatment of aortic arch malformations in infants under cardiopulmonary bypass

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