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,\rflow-mediated dilatation of the brachial artery, and distensibility and stiffness of the abdomi-\rnal aorta as early indicators of cardiovascular risk in children followed up after coarctation\rrepair.\rMaterials and Methods: Twenty patients with successful repair of coarctation and 27 healthy\rchildren were investigated. Two-dimensional echocardiographic images, and carotid and bra-\rchial ultrasound studies were performed.\rResults: The ages of the study group ranged from 5.3 to 22 years, and those of the control\rgroup from 7 to 17 years. The age at time of surgery was between 0.23 and 257 months.\rAverage follow-up duration after repair was between 11 and 257 months. The stiffness index of\rthe abdominal aorta was significantly higher in patients with coarctation repair than controls\r(mean = 0.625 ± 0.41, mean = 0.11 ± 0.73; P = .007). Flow-mediated dilatation of the bra-\rchial artery in the first minute decreased significantly among the patients (mean = 4.5 ± 2.7,\rmean = 6.9 ± 4.5; P = .005). Age of the patients had a negative correlation with distensibility of\rthe abdominal aorta (r = ?0.572; P = .008) and a positive correlation with stiffness of abdomi-\rnal aorta (r = 0.566, P = .009).\rConclusion: This study suggested that vascular wall changes in children and adolescents can\rbe seen even after successful coarctation repair and may progress toward overt atherosclero-\rsis at older ages