Vascular wall changes and arterial functions in children with surgically repaired aortic coarctation

Abstract

Objective: we investigated arterial functions by measuring carotid-intima-media thickness, flow-mediated dilatation of the brachial artery, and distensibility and stiffness of the abdominal aorta as early indicators of cardiovascular risk in children followed up after coarctation repair. Materials and methods: twenty patients with successful repair of coarctation and 27 healthy children were investigated. Two-dimensional echocardiographic images, and carotid and brachial ultrasound studies were performed. Results: the ages of the study group ranged from 5.3 to 22 years, and those of the control group from 7 to 17 years. The age at time of surgery was between 0.23 and 257 months. Average follow-up duration after repair was between 11 and 257 months. The stiffness index of the abdominal aorta was significantly higher in patients with coarctation repair than controls (mean = 0.625 +/- 0.41, mean = 0.11 +/- 0.73; P =.007). Flow-mediated dilatation of the brachial artery in the first minute decreased significantly among the patients (mean = 4.5 +/- 2.7, mean = 6.9 +/- 4.5; P =.005). Age of the patients had a negative correlation with distensibility of the abdominal aorta (r = -0.572; P =.008) and a positive correlation with stiffness of abdominal aorta (r = 0.566, P =.009). Conclusion: this study suggested that vascular wall changes in children and adolescents can be seen even after successful coarctation repair and may progress toward overt atherosclerosis at older ages.