A comparison of coarctation resection and patch angioplasty using postexercise blood pressure measurements.

Postexercise arm-to-leg blood pressure gradients were measured in 31 patients to determine the effectiveness of two surgical techniques for treating coarctation of the aorta. The arm-to-leg postexercise mean systolic blood pressure gradient was 29 mm Hg lower in 13 patients treated with Dacron patch angioplasty than in 18 patients whose coarctation was resected (p less than 0.01). Some patients with high postexercise gradients after coarctation resection had a reduced proximal aortic lumen by angiography. The results of this study indicate that Dacron patch angioplasty is the method of choice for effectively reducing postexercise systolic pressure gradients in patients with coarctation and hypoplasia of the aortic isthmus.