PubMed1982
The blood pressure of patients who underwent surgical correction of coarctation of the aorta are usually controlled at rest in the upper and lower extremities. The assessment of the success of the operation is then based on these blood-pressure readings. It is, however, more important to control the blood pressure during standardized exercise so that assessment of the capacity for work in daily life could be made. This is best realized with the bicycle ergometric examination with simultaneous blood-pressure readings 40 patients who had undergone surgical correction of the coarctation of the aorta, using the Vossschulte indirect patch aortoplasty method, were examined. The examination results were compared with those of 35 healthy children. The bicycle-ergometric exercise was carried out in stepwise increasing loads of up to 2 Watt/kg body weight. The blood-pressure, were compared based on the age of the patient at the time of the operation, in relation to the time between the operation and the ergometric examination and the age of the patient at the time of the operation. The W170 (Physical working capacity at a heart rate of 170) and the maximum oxygen intake of the subjects were also used as parameters for comparison. It could be seen that the initial blood pressure at rest was, on the average, relatively higher than those of the control subjects. This tendency was also observed during the bicycle-ergometric examination. In some subjects, the blood pressure rose to dangerously high values particularly at 2 Watt/kg body weight. The blood pressures of the patients remained on the average higher than those of the control subjects during the resting phase after the exercise (control after 1' and 5') and normalized relatively slowly. 45% of the patients showed pathological blood-pressure values. The W170 of the patients, a parameter for precise assessment of the cardiorespiratory fitness, was measured. The findings in the patients showed only very slight difference compared to those of normal subjects in all the assessment parameters. This applies also to the maximum oxygen supply, particularly when one considers the standard deviation. It is advisable to consider limitation of activities, for example sport, in the special cases where there are dangerously high blood-pressure rises during exercise even though no subjective complaints are made by the patients and the blood pressures at rest are normal. It is, on the whole, interesting to note that the operated patients compare very favourably with the control subjects in the W170 and the maximum oxygen-intake values.