Features of arterial pressure indicators in the postoperative period after surgical correction of aortic coarctation in children

Abstract

Coarctation of the aorta is a congenital heart disease, which is characterized by a local narrowing of the vessel lumen. Such a congenital anomaly of the aorta requires surgical treatment. Manifestations of the disease can be diagnosed in the first day after birth as well as some patients can be asymptomatic. Clinical signs of aortic coarctation are heart failure, hypertension in the upper extremities, hypotension in the lower extremities, ischemic manifestations in the organs, hemodynamic disorders. Untimely treatment of aortic anomalies leads to complications or death of patient. The results of 24-hour blood pressure monitoring in children after surgical correction of aortic coarctation are presented in the article. Despite the successful surgical treatment of congenital aortic malformation, the long-term results of the operation are far from satisfactory. Almost 12–18 % of the patients having undergone surgery continue to be hypertensive with the vascular dysfunction development and without signs of recoarctation. Patients receive antihypertensive medications, sometimes their combinations, for a long time. Assessment of the daily blood pressure profile features in the postoperative period would help determine pathogenetic mechanisms of the hypertensive syndrome persistence and predict the pathological process course. The aim of the study was to assess the arterial pressure indices in children after successful surgical treatment of coarctation of the aorta. Materials and methods. The main group consisted of 24 children after surgical correction of aortic coarctation. The control group consisted of 20 practically healthy children. Results. A statistically significant decrease in the average diastolic blood pressure during a 24-hour period and daytime diastolic blood pressure and an increase in the daily systolic blood pressure index were determined in the main group children based on the results of 24-hour blood pressure monitoring. Conclusions: The majority of children had low general well-being in the postoperative period. Indicators of systolic and diastolic blood pressure measured by Korotkov method (83.3 %) and 24-hour blood pressure monitoring parameters were typical for hypertension in majority of patients (66.7 %). Abnormalities of the circadian profile (“non-dipper”, “over-dipper”) were detected in 50.0 % of the main group children.

Keywords

• children
• hypertension
• ambulatory blood pressure monitoring