Predictive Value of Mild, Residual Descending Aortic Narrowing for Blood Pressure and Vascular Damage in Patients After Repair of Aortic Coarctation

Intima–media thickness measurements in children with cardiovascular risk factors

“…It was shown that even after coarctation repair, children with CoA had significantly greater CCA-IMT [75]. In some studies, it was found that carotid IMT is related to the degree of postoperative stenosis expressed as pressure gradient [75,76]. Because stenosis of the aorta diminishes the pulsatile component of the pulse wave below the stenosis, and because blood pressure in the lower parts of the body is lower than above the stenosis, one should expect that IMT in superficial femoral arteries should be lower than in healthy children.…”

“…To date, there are no data from a prospective study evaluating the cardiovascular risk in CoA patients in relation to IMT measurements. However, the significant increase of carotid IMT in the presence of even mild aortic narrowing and blood pressure gradient is a strong argument for earlier treatment of patients with residual gradient [76].…”

Optimal imaging protocol for evaluation of aortic coarctation; time for a reappraisal

“…Recently, it has been shown that in postcoarctectomy patients with no or only mild residual aortic narrowing mean daytime systolic blood pressure and carotid intima-media thickness (IMT) are independently associated with site of repair/diaphragmatic aorta ratio as assessed by MR imaging [14]. These novel and important findings suggest that, in patients who have been successfully repaired based on current guidelines, mild residual aortic narrowing may be of prognostic significance and may contribute to raised blood pressure and concomitant vascular damage.…”

Coarctation of the Aorta in the Adult

“…(8,10) Furthermore, an increased carotid intima-media thickness was found in young adults (11,12) and children (13) with CoA, as well as a diminished endothelium dependent and independent vasodilatation in the right brachial artery. (10,(13)(14)(15) …”