Lee C P, Lin T S, Chan P
Section of Cardiology, Chang Gung Medical Center, Lin-Kou, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 Mar;55(3):258-62.
Coarctation of aorta is a rare cause of secondary hypertension, premature death will occur if no appropriate treatment is given. Before 1980, the only effective treatment was surgery, and recurrent stenosis was frequent. After then several works on percutaneous transluminal angioplasty of this disease were reported, with promising short-term and long-term results, especially in children and young adults. This report concerns a 19-year-old male who had hypertension for four years; the hypertension was caused by coarctation of the aorta, confirmed by cardiac catheterization and angiography. Average blood pressure (BP) of his upper extremities was 200/110 mmHg which dropped to 150/90 mmHg immediately, and still two years, after angioplasty, whereas BP of the lower extremities maintained at about 150/80 mmHg measured by Korotkoff technique. Follow-up transesophageal echocardiography found no coarctation or aneurysm at the dilatation site one year later. Magnetic resonance imaging, performed two years later, showed an almost normal aortic wall at the coaxctation. The postoperative course was uneventful, and patient follow-up at the cardiology clinic has regularly shown an average BP around 150/80 mmHg.
主动脉缩窄是继发性高血压的罕见病因，若不给予适当治疗将会发生过早死亡。1980年以前，唯一有效的治疗方法是手术，且再狭窄很常见。此后有几篇关于该疾病经皮腔内血管成形术的研究报告，其短期和长期结果都很有前景，尤其是在儿童和青年成人中。本报告涉及一名19岁男性，他患有高血压四年；高血压由主动脉缩窄引起，经心导管检查和血管造影确诊。其上肢平均血压（BP）为200/110 mmHg，血管成形术后立即降至150/90 mmHg，两年后仍维持该水平，而下肢血压通过柯氏音法测量维持在约150/80 mmHg。一年后经食管超声心动图随访发现扩张部位无缩窄或动脉瘤。两年后进行的磁共振成像显示缩窄部位的主动脉壁几乎正常。术后过程顺利，在心脏病诊所对患者的随访定期显示平均血压约为150/80 mmHg。
