Paradoxical hypertension after repair of coarctation of the aorta in children: Balloon angioplasty versus surgical repair

Michael Choy, A. P. Rocchini, R. H. Beekman, A. Rosenthal, M. Dick, D. Crowley, D. Behrendt, A. R. Snider

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1186-1191
Number of pages6
JournalCirculation
Volume75
Issue number6
StatePublished - 1987
Externally publishedYes

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ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Choy, M., Rocchini, A. P., Beekman, R. H., Rosenthal, A., Dick, M., Crowley, D., Behrendt, D., & Snider, A. R. (1987). Paradoxical hypertension after repair of coarctation of the aorta in children: Balloon angioplasty versus surgical repair. Circulation, 75(6), 1186-1191.