HYPERTENSION IN ADULT AFTER OPERATION OF AORTIC COARCTATION

Aim. The benefit of coarctation repair on the resolution of systolic hypertension in adults has been questioned. Methods. Between March 1997 and July 2009, 65 consecutive adult patients (≥16 years) underwent repair of aortic coarctation. There were 40 men (65%) and 25 women (35%) with a mean age of 22.3±4.8 years (range, 16 to 34 years). All patients had critical systolic blood hypertension (SBP ≥140 mmHg). SBP ranged from 140 to 205 mmHg, with a mean of 163.5±17.6 mmHg. The mean diastolic BP was 95.1±18.3 mmHg (range, 70 to 120 mmHg). Most patients (41/65, 74%) were on a regimen of at least one antihypertensive drug. Results. The patients were followed up after coarctation repair for 2 to 144 months (mean, 68±39 months). There was no death. No other major complications occurred. There have been no repeat interventions during follow-up. Four patients were lost to follow-up. Of the 61 patients with preoperative hypertension, 53 (87%) were normotensive (SBP <140 mmHg) at the most recent follow-up visit. The remaining eight patients showed substantial improvement versus the preoperative status. The mean SBP after operation was 122.5±12.4 mmHg. Mean diastolic blood pressure was 79.5±11.6 mmHg. Forty-one (67%) patients were taking no medication at the last follow-up. Conclusion. Surgical repair of coarctation of the aorta in adults can lead to regression of systolic hypertension and a decreased requirement for antihypertensive medication.