Skip to main content
SpringerLink
Log in

Impaired Elastic Properties of the Ascending Aorta Persist Within the First 3 Years After Neonatal Coarctation Repair

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Abnormal elastic properties of the ascending aorta in patients with coarctation of the aorta (CoA) are already present in neonates before and after successful repair. To prove the midterm outcome for vascular pathology, a cohort of 15 patients was prospectively reevaluated. In this study, 15 patients after neonatal CoA repair (study group) and 15 healthy normal children (control group) were examined (mean age, 3.0 ± 1.0 years). The aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic M-mode diameters and noninvasive estimation of pulse pressure. The study group was compared with the control group and with its own previously obtained pre- and postoperative measurements. After a mean follow-up period of 2.9 ± 0.9 years, the elastic properties of the ascending aorta remained impaired in the study group compared with the control group (distensibility: 62 ± 28 vs 94 ± 34; p = 0.01; stiffness index: 4.4 ± 1.9 vs 2.7 ± 1.0; p = 0.008). At follow-up evaluation, the elasticity of the ascending aorta in the study group showed no change from the initial neonatal findings (distensibility: 63 ± 24 vs 62 ± 28; p = 0.82; stiffness index: 4.0 ± 1.6 vs 4.4 ± 1.9; p = 0.65). In both groups, descending aortic elasticity increased during the follow-up period. Our data suggest that the diminished elastic properties of the prestenotic arteries remain unchanged years after successful CoA repair. Comparisons with the neonatal data showed no evidence for remodeling of the ascending aorta in this group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Baumgartner D, Baumgartner C, Matyas G et al (2005) Diagnostic power of aortic elastic properties in young patients with Marfan syndrome. J Thorac Cardiovasc Surg 129:730–739

    Article  PubMed  Google Scholar 

  2. Borow KM, Newburger JW (1982) Noninvasive estimation of central aortic pressure using the oscillometric method for analyzing systemic artery pulsatile blood flow: comparative study of indirect systolic, diastolic, and mean brachial artery pressure with simultaneous direct ascending aortic pressure measurements. Am Heart J 103:879–886

    Article  PubMed  CAS  Google Scholar 

  3. Boutouyrie P, Tropeano AI, Asmar R et al (2002) Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients. Hypertension 39:10–15

    Article  PubMed  CAS  Google Scholar 

  4. Brili S, Tousoulis D, Antoniades C et al (2005) Evidence of vascular dysfunction in young patients with successfully repaired coarctation of aorta. Atherosclerosis 182:97–103

    Article  PubMed  CAS  Google Scholar 

  5. Cohen M, Fuster V, Steele PM et al (1989) Coarctation of the aorta: long-term follow-up and prediction of outcome after surgical correction. Circulation 80:840–845

    PubMed  CAS  Google Scholar 

  6. Daniels SR (2001) Repair of coarctation of the aorta and hypertension: does age matter? Lancet 358:89

    Article  PubMed  CAS  Google Scholar 

  7. de Divitiis M, Pilla C, Kattenhorn M et al (2001) Vascular dysfunction after repair of coarctation of the aorta: impact of early surgery. Circulation 104:165–170

    Google Scholar 

  8. Dernellis J, Panaretou M (2005) Aortic stiffness is an independent predictor of progression to hypertension in nonhypertensive subjects. Hypertension 45:426–431

    Article  PubMed  CAS  Google Scholar 

  9. Eicken A, Pensl U, Sebening W et al (2006) The fate of systemic blood pressure in patients after effectively stented coarctation. Eur Heart J 27:1100–1105

    Article  PubMed  Google Scholar 

  10. Gardiner HM, Celermajer DS, Sorensen KE et al (1994) Arterial reactivity is significantly impaired in normotensive young adults after successful repair of aortic coarctation in childhood. Circulation 89:1745–1750

    PubMed  CAS  Google Scholar 

  11. Heger M, Willfort A, Neunteufl T et al (2005) Vascular dysfunction after coarctation repair is related to the age at surgery. Int J Cardiol 99:295–299

    Article  PubMed  Google Scholar 

  12. Kim GB, Kang SJ, Bae EJ et al (2004) Elastic properties of the ascending aorta in young children after successful coarctoplasty in infancy. Int J Cardiol 97:471–477

    Article  PubMed  Google Scholar 

  13. Laurent S, Boutouyrie P, Asmar R et al (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37:1236–1241

    PubMed  CAS  Google Scholar 

  14. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children, Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  15. O’Sullivan JJ, Derrick G, Darnell R (2002) Prevalence of hypertension in children after early repair of coarctation of the aorta: a cohort study using casual and 24-hour blood pressure measurement. Heart 88:163–166

    Article  PubMed  CAS  Google Scholar 

  16. Ong CM, Canter CE, Gutierrez FR et al (1992) Increased stiffness and persistent narrowing of the aorta after successful repair of coarctation of the aorta: relationship to left ventricular mass and blood pressure at rest and with exercise. Am Heart J 123:1594–1600

    Article  PubMed  CAS  Google Scholar 

  17. Ou P, Celermajer DS, Mousseaux E et al (2007) Vascular remodeling after “successful” repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol 49:883–890

    Article  PubMed  Google Scholar 

  18. Polson J, McCallion N, Waki H et al (2006) Evidence for cardiovascular autonomic dysfunction in neonates with coarctation of the aorta. Circulation 113:2844–2850

    Article  PubMed  Google Scholar 

  19. Sahn A, DeMaria DJ, Kisslo J, Weyman A (1978) Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 58:1072–1083

    PubMed  CAS  Google Scholar 

  20. Vogt M, Kühn A, Baumgartner D et al (2005) 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? Circulation 111:3269–3273

    Article  PubMed  Google Scholar 

  21. Wessel A, von Samson-Himmelstjerna MC, Ruschewski W, Bursch JH (1995) Effects of age in the correction of isthmus stenosis on postoperative stiffness of the aorta. Z Kardiol 84:237–242

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Lazarettstrasse 36, 80636, München, Germany

    Andreas Kühn, John Hess & Manfred Vogt

  2. Clinical Division of Pediatric Cardiology, Innsbruck Medical University, Innsbruck, Austria

    Daniela Baumgartner

  3. Research Group for Clinical Bioinformatics, University for Health Sciences, Medical Informatics, and Technology, Hall, Austria

    Christian Baumgartner

  4. Department of Cardiovascular Surgery, Deutsches Herzzentrum München, München, Germany

    Jürgen Hörer & Christian Schreiber

Authors
  1. Andreas Kühn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Baumgartner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Baumgartner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jürgen Hörer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Schreiber
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. John Hess
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Manfred Vogt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manfred Vogt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kühn, A., Baumgartner, D., Baumgartner, C. et al. Impaired Elastic Properties of the Ascending Aorta Persist Within the First 3 Years After Neonatal Coarctation Repair. Pediatr Cardiol 30, 46–51 (2009). https://doi.org/10.1007/s00246-008-9280-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-008-9280-6

Keywords

Search

Navigation