[Clinical and magnetic resonance tomography follow-up of surgically treated aortic isthmus stenoses in adults].

Functional impairment and local pathological changes of the aorta especially at the site of correction are well known complications after surgery for coarctation of the aorta. To evaluate the longterm results after this operation, 23 patients were assessed by physical examination, EKG, ergometry, spirometry, and magnetic resonance imaging. The postsurgical interval ranged from 1 to 28 years. The most frequent postoperative symptoms were vertigo, headache, dyspnea on exertion, cardiac arrhythmia, and left thoracic pain. Elevation of the left shoulder was found in 19 patients to be due to left lateral thoracotomy; 14 patients suffered from arterial hypertension; five additional patients showed hypertension on exertion. Magnetic resonance imaging showed pathological changes of the aorta and aortic branches in all patients. The origin of the left subclavian artery was displaced distally in eight patients. The proximal part of the left subclavian artery was dilated in 11 patients. Fourteen patients had a hypoplastic aortic arch. An aneurysm of the ascending aorta was found in five patients. Aneurysmal dilatation of the descending aorta in the region of the anastomosis was present in three patients. Restenosis of the descending aorta occurred in two patients. In conclusion, after surgery of coarctation many patients continued to have symptoms which require regular follow-up. Magnetic resonance imaging provides a complete and noninvasive examination of the heart and the great vessels and is therefore ideally suited for this purpose.