Surgical Approach for Aortic Coarctation Influences Arterial Compliance and Blood Pressure Control

Kenny, Damien; Polson, Jaimie W.; Martin, Robin P.; Wilson, Dirk G.; Caputo, Massimo; Cockcroft, John R.; Paton, Julian F. R.; Wolf, Andrew

doi:10.1016/j.athoracsur.2010.04.098

Cited by 30 publications

(23 citation statements)

References 29 publications

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“…In accordance with studies for hypertension, end-to-end anastomosis is the preferable surgical technique, as it is not associated with impaired vascular function contrary to the subclavian fl ap repair [ 63 ]. Plausible mechanisms are an ongoing regional effect of residual "coarctation" tissue on the upper limb arterial dynamics in subclavian fl ap repair compared with the fully resected anastomosis approach and earlier refl ected waves from the subclavian fl ap repair site due to subclavian artery's different wall structure or due to a more diffuse scar site that may lead to greater augmentation of central systolic pressure and abnormal arterial compliance through increased mechanical forces.…”

Section: Arterial Function and Structure In Relation To Repairsupporting

confidence: 63%

Arterial Stiffness and Risk in Various Cardiovascular Diseases

Vlachopoulos

Terentes‐Printzios

Takazawa

et al. 2014

Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

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Atherosclerotic disease comprises four major areas: coronary artery disease, cerebrovascular disease, peripheral arterial disease, and aortic aneurysm. Investigators have mainly focused on using arterial stiffness and central hemodynamics indices for primary prevention and prediction of risk in patients without cardiovascular disease. Their role in these patients is constantly evolving, and in some cases such as hypertensives and diabetics, their clinical signifi cance has been corroborated by recent guidelines and recommendations. Despite the overwhelming data for their predictive role in primary prevention, secondary prevention prognostic studies are lacking. Especially, data on the role of arterial stiffness in peripheral arterial disease patients, including patients with vasculogenic erectile dysfunction or aortic disease such as aortic aneurysm, Marfan syndrome, and coarctation of the aorta, emerge mostly from cross-sectional studies. Respectively, most prospective predictive studies of arterial stiffness have not used peripheral arterial disease or aortic disease endpoints as an exclusive outcome but preferably as a part of a composite cardiovascular endpoint. This chapter will focus on the link between arterial stiffness and risk of cardiovascular events and organ damage in other cardiovascular diseases such as peripheral arterial and aortic diseases.

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Section: Arterial Function and Structure In Relation To Repairsupporting

confidence: 63%

Arterial Stiffness and Risk in Various Cardiovascular Diseases

Vlachopoulos

Terentes‐Printzios

Takazawa

et al. 2014

Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

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“…Surgical experience may be important in the occurrence of recoarctation and aneurysm formation; however, serious complications seem to be more frequent after SFR than after end‐to‐end repair . A recent report indicated that SFR may influence the development of arterial dysfunction in the upper limbs and subsequent hypertension independent of recoarctation …”

Section: Discussionmentioning

confidence: 99%

“…21 A recent report indicated that SFR may influence the development of arterial dysfunction in the upper limbs and subsequent hypertension independent of recoarctation. 22 With the development of two different surgical strategies, single-stage and two-stage repairs, the mortality and morbidity of CoA and complex intracardiac lesions has dramatically improved. Quaegebeur et al 23 suggested that when a VSD is present, pulmonary artery banding was safer than single-stage repair; however, some surgeons have demonstrated that single-stage repair was never inferior to two-stage correction.…”

Section: Discussionmentioning

confidence: 99%

Aortic Coarctation Repair in Neonates with Intracardiac Defects: The Importance of Preservation of the Lesser Curvature of the Aortic Arch

et al. 2014

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“…There are also evidences that the type of surgical intervention could influence the prevalence of hypertension in long term. In particular, patients undergoing end-to-end anastomosis have a lower systolic blood pressure at follow-up than those undergoing subclavian flap repair or patch aortoplasty 2,9,10 . However other Authors report no significant differences in the prevalence of hypertension in relation to surgical repair techniques 11,12 .…”

mentioning

confidence: 99%

Abnormalities of aortic arch shape after successful repair of aortic coarctation and systemic arterial hypertension

Crepaz¹

2018

J Pediatrics & Pediatr Med

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After successful repair of aortic coarctation (AoCo), many patients remain at risk for cardiovascular problems and major adverse prognostic factors have been identified [1][2][3][4] . After AoCo repair, different pathogenic mechanisms leading to persistent systemic arterial hypertension have been identified, including mild residual arch stenosis, increased aortic wall stiffness, hyperactivity of reninangiotensin system, impairment of the baroreflex system and peripheral vascular reactivity 4 .An abnormal aortic arch shape has been associated with rest or exercise-induced arterial hypertension in the long-term follow-up of patients after repair of AoCo, without any residual arch obstruction 3,5 . Native aortic arch morphology, age at repair and surgical approach were all identified as possible causes for a persistent postoperative abnormal arch shape; however all these findings are still debated. An abnormal arch shape with either gothic or crenel morphology after surgical repair leads to an abnormal central aortic flow dynamic and increased aortic wall stiffness 6 , which can both contribute to the development of systemic arterial hypertension in the long-term 7,8 (see Figure 1 and Figure 2).

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Surgical Approach for Aortic Coarctation Influences Arterial Compliance and Blood Pressure Control

Cited by 30 publications

References 29 publications

Arterial Stiffness and Risk in Various Cardiovascular Diseases

Arterial Stiffness and Risk in Various Cardiovascular Diseases

Aortic Coarctation Repair in Neonates with Intracardiac Defects: The Importance of Preservation of the Lesser Curvature of the Aortic Arch

Abnormalities of aortic arch shape after successful repair of aortic coarctation and systemic arterial hypertension

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