Clinical InvestigationVascular and Congenital Heart DiseaseIncreased carotid and femoral intima-media thickness in patients after repair of aortic coarctation: Influence of early repair
Section snippets
Study design
From 2001 until 2002, all 137 consecutive adult postcoarctectomy patients (89 male) from the outpatient clinic of our tertiary referral institution and 46 age-matched, normotensive, healthy volunteers were enrolled in this observational study. The institutional review committee approved the protocol and an informed consent was obtained from all participants. In all patients, significant residual aortic stenosis or recoarctation had been ruled out by magnetic resonance imaging within 2 years
Patient population
Median age of the 137 patients after repair of aortic coarctation (89 male) was 29.7 years (range 17.1-74.3 years). Median age at repair was 6.3 years (range 0.01-45.7 years). Twenty patients (15%) were operated on before the age of 1 year (“early repair”). Nine of these patients had neonatal repair (before the age of 1 month). Table I shows the clinical characteristics in patients with early or late repair and controls. Seventy-three percent of the patients had resection and end-to-end
Discussion
Our study demonstrates for the first time that both carotid and femoral IMT are increased in young patients after successful repair of aortic coarctation compared to controls. The differences in carotid IMT are prominent, even in patients with early repair. In contrast to earlier assumptions, postcoarctation arterial wall structure is not normal; femoral IMT is increased even in patients with early aortic coarctation repair. Age at repair was shown an independent predictor of femoral IMT but
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