Cohen J R, Birnbaum E
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
J Vasc Surg. 1988 Aug;8(2):160-4.
Coarctation of the abdominal aorta remains a surgically treatable cause of hypertension in children and young adults. Average age of the patients is 21 years at the time of diagnosis and a second peak in the fourth to fifth decade. If left untreated, most patients die as a result of complications from untreated hypertension by the age of 35 years. Aortography remains the diagnostic test of choice with associated visceral and renal artery stenoses occurring in 26% of cases. Of the 146 cases reported, 109 had surgical treatment with an operative mortality rate of 6.9%. Of those patients having surgery 96% were normotensive or were easily controlled postoperatively with antihypertensive medications. Because claudication is a minor problem in most cases, surgical correction of the hypertension by hepatorenal or splenic-renal bypasses may be the preferred initial surgical treatment in patients without significant visceral artery involvement or severe symptomatic lower extremity ischemia.
腹主动脉缩窄仍是儿童和青年高血压的一种可通过手术治疗的病因。患者诊断时的平均年龄为21岁，在第四至第五个十年出现第二个高峰。如果不进行治疗，大多数患者在35岁时会因未治疗的高血压并发症而死亡。主动脉造影仍是首选的诊断检查，26%的病例伴有内脏和肾动脉狭窄。在报告的146例病例中，109例接受了手术治疗，手术死亡率为6.9%。在接受手术的患者中，96%血压正常或术后使用抗高血压药物很容易控制血压。由于在大多数情况下间歇性跛行是一个小问题，对于没有明显内脏动脉受累或严重症状性下肢缺血的患者，通过肝肾或脾肾旁路手术纠正高血压可能是首选的初始手术治疗方法。
