Objectives: Despite successful surgical repair, post-coarctectomy patients suffer from early onset cardiovascular disease (CVD). Enhanced pressure wave reflections and increased arterial stiffness have been proposed to explain the increased risk of CVD. We therefore assessed arterial wave reflections and arterial stiffness in post-coarctectomy patients and matched controls.

Methods: We examined 10 post-coarctectomy patients aged 29 ±7 yrs, 7 males, without significant restenosis and without antihypertensive treatment. Ten healthy age and gender matched subjects served as controls (age 26 ±2 yrs, 6 males). Radial artery waveforms were recorded non-invasively by applanation tonometry using the Sphygmocor device. Aortic augmentation index (AIx) was calculated using a validated transfer function and corrected for heart rate. Pulse wave velocity (PWV) was measured between carotid and femoral arteries. All measurements were performed three times on the right and left side and were averaged.

Results: Post-coarctectomy patients had a higher right-sided (11.4±16.8 vs −12.4±8.8, p <0.01) and left-sided (22.5±7.9 vs −10.5±10.4, p <0.01) AIx compared to healthy controls. Carotid-femoral PWV showed no difference between patients and controls (right 5.7±0.9 vs 5.8±0.9, p =0.70; left 5.5±0.7 vs 5.7±0.8, p 0=.44).

Conclusions: Augmentation index is increased in post-coarctectomy patients. The finding of normal arterial stiffness combined with a distinct right to left difference in augmentation suggests that the enhanced wave reflection likely arises from early pulse wave reflection on the reconstructed aorta despite the absence of significant restenosis.