Low Peak dP/dt in the Descending Aorta in Patients After Successful Aortic Arch Repair.

One of the most important problems in patients with aortic coarctation or interruption of the aortic arch after successful aortic arch repair is developing cardiovascular disease in the future. It has been reported that the repaired site is stiff and generates a new pressure wave reflection, which could lead to cardiovascular disease. The purpose of this study was to clarify the influence of the repaired portion's stiffness on the pressure waveform in patients. Fifteen patients (age: 7.4 ± 3.2 years) who had successful aortic arch repair were enrolled. Their peak dP/dt in the ascending aorta (AAo) and the descending aorta (DAo) were compared with those of age-matched controls with a normal aortic arch. The ascending and descending aortic systolic blood pressures in aortic arch repair patients were higher than those in age-matched controls (AAo: 103.1 ± 13.3 vs. 91.9 ± 9.2 mmHg, p = 0.012 and DAo: 108.7 ± 16.4 vs. 96.5 ± 9.9 mmHg, p = 0.020). Although no difference existed in the peak dP/dt in the AAo between the aortic arch repair patients and the controls (572.1 ± 100.1 vs. 543.3 ± 110.2 mmHg/s, p = 0.460), the peak dP/dt in the DAo in the aortic arch repair patients was significantly lower than that in the controls (489.3 ± 75.2 vs. 579.4 ± 106.0 mmHg/s, p = 0.013). The peak dP/dt in the DAo in aortic arch repair patients is low. The stiff repaired site may attenuate pulsation.