Impaired elastic properties of the ascending aorta in newborns before and early after successful coarctation repair: proof of a systemic vascular disease of the prestenotic arteries?

Vogt, M; Kuhn, A; Baumgartner, D; Baumgartner, C; Busch, R; Kostolny, M; Hess, J

doi:10.1161/CIRCULATIONAHA.104.529792

2005

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Document type:: Journal Article; Article
Author(s):: Vogt, M; Kuhn, A; Baumgartner, D; Baumgartner, C; Busch, R; Kostolny, M; Hess, J
Title:: Impaired elastic properties of the ascending aorta in newborns before and early after successful coarctation repair: proof of a systemic vascular disease of the prestenotic arteries?
Abstract:: BACKGROUND: Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. To find out whether these abnormalities are primarily present or develop later, we studied 17 newborns before and early after surgical repair. METHODS AND RESULTS: Aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic diameters determined by M-mode echocardiography and noninvasive estimation of aortic pulse pressure in the right arm and leg. Seventeen patients with aortic coarctation (mean age, 20+/-26 days) were compared with 17 normal neonates (mean age, 13+/-7 days) preoperatively and postoperatively (10+/-6 days after surgery). Ascending aortic distensibility in patients was significantly reduced preoperatively (79+/-58 versus 105+/-36; P=0.03) and postoperatively (65+/-24 versus 105+/-36; P<0.005). Preoperative and postoperative ascending aortic stiffness index was higher in patients (preoperative, 5.2+/-4.4 versus 2.7+/-0.9; P=0.04; postoperative, 4.0+/-1.6 versus 2.7+/-0.9; P<0.005). Elastic properties of the descending aorta did not differ preoperatively or postoperatively compared with those in normal subjects. CONCLUSIONS: Elastic properties of the prestenotic aorta of patients with coarctation seem to be impaired primarily, even in neonates, and remain unchanged early after successful operation. Surgical correction does not resolve inborn pathology of the prestenotic aortic vascular bed.
Journal title abbreviation:: Circulation
Year:: 2005
Journal volume:: 111
Journal issue:: 24
Pages contribution:: 3269-73
Language:: eng
Fulltext / DOI:: doi:10.1161/CIRCULATIONAHA.104.529792
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/15956120
Print-ISSN:: 0009-7322
TUM Institution:: Institut für Medizinische Statistik und Epidemiologie; Klinik für Herz- und Gefäßchirurgie (Prof. Lange); Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Hess)
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