Key result
Balloon angioplasty for aortic coarctation linked to no paradoxical hypertension vs surgical repair.
Why the study?
The incidence and causes of paradoxical hypertension after repair of coarctation of the aorta in children were not well characterized for balloon angioplasty versus surgical repair.
Does balloon angioplasty prevent paradoxical hypertension compared to surgical repair in children with coarctation of the aorta?
Cohort (n=15)
Does balloon angioplasty prevent paradoxical hypertension compared to surgical repair in children with coarctation of the aorta?
Balloon angioplasty avoids the paradoxical hypertension and neurohormonal activation typically seen after surgical repair of aortic coarctation in children.
Answers are grounded in this paper and cite their sources.
May favor balloon angioplasty to avoid paradoxical hypertension in pediatric coarctation; hypothesis-generating and requires randomized confirmation before practice change.
The incidence and possible causes of paradoxical hypertension were evaluated in eight children who underwent balloon dilatation and seven children who underwent surgical repair of coarctation of the aorta. Both procedures resulted in a significant reduction in the coarctation gradient. Both systolic and diastolic blood pressures increased in the surgical group after repair, whereas systolic pressures decreased and diastolic pressures remained unchanged after balloon angioplasty. In the surgical group, but not in the balloon angioplasty group, plasma catecholamines and plasma renin activity rose during the first 2 days after relief of the coarctation. The data presented in this report support the hypothesis that the sympathetic nervous system and the renin angiotensin system are important mediators of the paradoxical hypertension that occurs after surgical repair of coarctation. Furthermore, balloon angioplasty of coarctation of the aorta does not stimulate either system and thus paradoxical hypertension is not a complication of this procedure.
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Choy et al. (1987) conducted a cohort in Coarctation of the aorta (n=15). Balloon angioplasty vs. Surgical repair was evaluated on Incidence and possible causes of paradoxical hypertension (blood pressure, plasma catecholamines, and plasma renin activity). Balloon angioplasty for coarctation of the aorta did not cause paradoxical hypertension or stimulate the sympathetic and renin-angiotensin systems, unlike surgical repair.
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