Ozyazicioğlu Ahmet, Ateş Azman, Yekeler Ibrahim, Balci Ahmet Yavuz, Bozkurt Engin
Department of Caridiovascular Surgery, Atatürk University Aziziye Hospital, Erzurum, Turkey.
Cardiovasc Surg. 2003 Oct;11(5):353-7. doi: 10.1016/S0967-2109(03)00107-8.
The aim of this study is to determine if surgical repair of coarctation in adults improves systemic hypertension. The charts of 23 consecutive patients (age range 13-36 years, mean 23.6+/-7) who underwent repair of aortic coarctation at the Atatürk University, Aziziye Hospital, between 1986 and 2000 were reviewed. There were 16 (70%) men and seven (30%) women. All patients had preoperative hypertension. Systolic blood pressure (BP) ranged between 150 and 200 mmHg, with a mean of 176+/-15 mmHg. Peak systolic gradient across the coarctation was 52+/-20 mmHg (range from 30 to 112 mmHg). There were no early or late deaths. Mean systolic BP values at the first postoperative evaluation were 176+/-15 mmHg (p<0.001 from preoperative values). Exercise testing revealed hypertensive response to exercise in three of 10 patients who had borderline hypertension at rest and without medication. Repair of coarctation of aorta even in adults is safe and improves systemic hypertension. To identify patients with potential hypertension, exercise testing should be performed. Impaired arterial dilatation may be an important contributor to exercise-related hypertension and late morbidity or mortality.
本研究的目的是确定成人主动脉缩窄的手术修复是否能改善系统性高血压。回顾了1986年至2000年间在阿塔图尔克大学阿齐济耶医院接受主动脉缩窄修复术的23例连续患者（年龄范围13 - 36岁，平均23.6±7岁）的病历。其中男性16例（70%），女性7例（30%）。所有患者术前均患有高血压。收缩压范围在150至200 mmHg之间，平均为176±15 mmHg。缩窄部位的收缩期峰值梯度为52±20 mmHg（范围为30至112 mmHg）。无早期或晚期死亡病例。术后首次评估时的平均收缩压值为176±15 mmHg（与术前值相比，p<0.001）。运动测试显示，10例静息时血压临界且未服药的患者中有3例对运动有高血压反应。即使是成人，主动脉缩窄修复术也是安全的，且能改善系统性高血压。为识别潜在高血压患者，应进行运动测试。动脉扩张受损可能是运动相关性高血压及晚期发病或死亡的重要原因。
