Blood pressure response to exercise in children following the subclavian flap procedure for coarctation of the aorta.

Eight patients who underwent repair of coarctation of the aorta as infants (mean age 4.6 months) by the subclavian flap procedure were evaluated by dynamic exercise. Their mean age at the time of exercise testing was 4.6 years. Resting upper to lower limb systolic blood pressure gradients were similar in the patients and control subjects (mean 17 +/- 12 and 2 +/- 14 mm Hg) (p greater than 0.05). Mean resting systolic blood pressures in the upper limb were 121 +/- 10 mm Hg in the patients and 107 +/- 14 mm Hg in the volunteers (p greater than 0.05). The mean gradient between the upper and lower limbs was 13 +/- 19 mm Hg in the patients on dynamic exercise testing. No patient became pathologically hypertensive in the upper limbs during dynamic exercise. These results indicate that the subclavian flap procedure is an effective form of treatment for the symptomatic infant with coarctation of the aorta and can be expected to result in a low incidence of subclinical residual obstruction or restenosis.