Post-Operative Blood Pressures in Coarctation of the Aorta

Gross and Hufnagel (1945) and Crafoord and Nylin (1945) independently reported successful repair of the coarctation of aorta.Since then many thousand patients have had surgical correction of this anomaly (Bailey, 1957; Campbell and Baylis, 1956; Cleland et al., 1956; Keith, Rowe, and Vlad, 1958).There have been numerous reports dealing with the immediate post-operative period (d'Abreau and Parsons, 1956) but very few long-term follow-up studies have been carried out either in children or in the older age-groups.This report deals with the follow-up results of the patients operated upon for coarctation of aorta, from birth to 15 years of age, at the Hospital for Sick Children, Toronto.SUBJECTS Records of 150 patients operated upon for coarctation of aorta at the Hospital for Sick Children during the past 15 years were reviewed.The cases were divided into two groups.In infant Group A, 27 were operated on during the first year of life, and in child Group B, 123 patients were operated on between 1 and 15 years of age.Patients in Group A were followed from 6 months to 11 years with a mean follow-up of 5 1 years.Of the 123 patients in Group B, 32 were followed from 6 months to 11 years with a mean follow-up of 4-4 years.Blood pressures in the right arm and one of the lower extremities were measured by the conven- tional blood-pressure cuff and checked by an oscillometer when necessary in infancy (Keith et al., 1958).Of the infants in Group A, 24 per cent and of the children in Group B, 26 per cent had some associated cardiac defect.Patent ductus arteriosus was the most common anomaly found in conjunction with coarctation, The other anomalies included ventricular septal defect, atrial septal defect, aortic stenosis, aortic regurgi- tation endocardial fibro-elastosis, and mitral regurgitation (Glass, Mustard, and Keith, 1960).