Limited effect of early repair on carotid arterial wall stiffness in adult post-coarctectomy patients: In response to the article by Heger M, Willfort A, Neunteufl T, Rosenhek R, Gabriel H, Wollenek G, Wimmer M, Maurer G, Baumgartner H. Vascular dysfunction after coarctation repair is related to the age at surgery. Int J Cardiol 2004; in press

Abstract

We read with great interest the paper by Hager et al. who report impaired brachial endothelium-dependent flow-mediated dilation (FMD) and endothelium-independent nitroglycerin-mediated dilation (NMD) in adult patients after repair of aortic coarctation [1]. The authors found significantly lower FMD and NMD in 14 patients with aortic coarctation repair after the age of 9 years compared to 22 patients with repair before the age of 9 years. However, in univariate regression analysis the relations between FMD or NMD and age at repair were not significant. This is consistent with our results in a study of 127 adult post-coarctectomy patients. From 2001 until 2002, 127 consecutive adult post-coarctectomy patients (82 male) from our tertiary referral centre were studied by M-mode ultrasound imaging of the carotid arteries. In all patients significant residual aortic stenosis or recoarctation had been ruled out by magnetic resonance imaging within two years before the start of this study. Mean age was 30F10 years (range 17–71 years) and age at repair was 7.3F6.2 years