J Thorac Cardiovasc Surg 2008;135:1405-1406
© 2008 The American Association for Thoracic Surgery
Hypertension in coarctation
Francis Robicsek, MD, PhD
Carolinas Heart Institute, Carolinas Medical Center, Charlotte, NC 28203
To the Editor:
I read with great interest the article by Hager and associates1
on coarctation repair. The authors note that the majority of patients remained hypertensive in the long term, even after coarctation repair. This very interesting phenomena, however, has to be examined in the mirror of the little known fact that most patients are often hypertensive below the level of the coarctation even before the coarctation is repaired! While pressure measurements indeed show significantly higher pressures above the coarctation, the mean arterial pressure below the coarctation is also higher than that of an average normal subject. Thus, arterial hypertension observed after coarctation repair is not a new phenomenon, but is simply the continuation of the neurosympathetic process that existed before the coarctation repair.
References
- Hager A, Kanz S, Kaemmerer H, Schreiber C, Hess J. 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. J Thorac Cardiovasc Surg 2007;134:738-745.[Abstract/Free Full Text]
