Non-invasive evaluation of the long-term results of coarctectomy in childhood.

Nineteen young men operated upon for coarctation of the aorta in childhood were studied with pulse tracings from the femoral and carotid arteries and echocardiographic examination of the heart with estimation of the degree of hypertrophy and valve anomalies. The results were compared with intra-arterial blood-pressure measurements and angiographically measured width of the aortic anastomosis. Patients with markedly distorted pulse curves had the narrowest anastomoses although no uniform pattern could be detected. Although one of the selection criteria was 'no other known cardiovascular malformations', only three of the patients had completely normal aortic and mitral valves. Nine of the patients had left ventricular hypertrophy but the degree of hypertrophy could not be correlated to the degree of arterial hypertension. The importance of long-term follow-up of these patients, who in spite of surgery have a remaining cardiovascular excess mortality, is emphasized. Pulse tracings and echocardiography seem to be of value for this purpose.