Late hypertension after repair of coarctation of aorta

Lee, Chang Hoon; Choi, Eun Young; Kwon, Bo Sang; Kim, Gi Beom; Bae, Eun Jung; Noh, Chung Il; Choi, Jung Yun; Yun, Yong Soo; Kim, Woong Han; Lee, Jeong Ryul; Kim, Yong Jin

Abstract

PURPOSE: Late hypertension (HT) after coarctoplasty occurs commonly. This study was performed to evaluate the relationships between late HT and associated factors to it.
METHODS
Retrospective analysis of the medical records of 22 apparently healthy patients who had coarctoplasty during infancy and were followed up for more than 10 years was done. Casual blood pressure (BP) was obtained in all and 24 hour BP monitoring was obtained in 16. Echocardiogrphic Doppler flow velocity at coarctation of aorta (COA) repair site and left ventricular (LV) indexes were also obtained. The ratio of the narrowest diameter of aortic arch and the diameter of the descending aorta at the diaphragmatic level was obtained through 3-dimentional computed tomography.
RESULTS
HT by casual BP was detected in 7 of 22 and HT by 24 hour BP monitoring in 10 of 16. Three were normotensive by casual BP, but hypertensive by 24 hour BP monitoring. Males predominated in patients with HT by casual BP (P=0.022) and by 24 hour BP monitoring (P=0.036). Doppler velocity at COA repair site was higher in HT group by casual BP (P=0.006) and also in HT group by 24 hour BP monitoring (P=0.041). Especially, patients with a velocity of over 3 m/sec were more in HT group by casual BP (P=0.026).
CONCLUSION
Even if casual BP is normal, there can be hypertension by 24 hour BP monitoring. So every postoperative patient has to get 24 hour BP monitoring. Especially in patients with Doppler velocity at COA site over 3 m/sec, 24 hour BP monitoring should be done to define HT.