Unmasking the borderline coarctation: The utility of isoproterenol in the paediatric cardiac catheterisation laboratory

Neil D. Patel, Patrick M. Sullivan, Cheryl M. Takao, Sarah Badran, Joseph Ahdoot, Frank Ing

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background One indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state.Objectives We aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients.Methods A retrospective study was performed on two-ventricle patients who underwent cardiac catheterisation for coarctation with isoproterenol testing.Results 25 patients received isoproterenol before and after intervention. With isoproterenol, the mean diastolic (p=0.0015) and mean arterial (p=0.0065) blood pressures proximal to the coarctation decreased significantly. The mean systolic, diastolic, and mean arterial blood pressures distal to the coarctation decreased significantly (p<0.0001). In patients with a baseline gradient â

Original languageEnglish (US)
Pages (from-to)804-810
Number of pages7
JournalCardiology in the Young
Volume28
Issue number6
DOIs
StatePublished - Jun 1 2018

Keywords

  • Coarctation
  • exercise testing
  • isoproterenol
  • stent

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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