General Hemodynamics and Splanchnic Circulation in Patients with Coarctation of the Aorta1

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Abstract
Ten patients were studied by standard clinical physiologic circulatory methods to determine total and regional (especially abdominal visceral) blood flow rates and to estimate the degree and distribution of peripheral arteriolar resistance in circuits above and below the aortic constriction. Conclusions: The hemodynamic pattern associated with coarctation of the aorta in 10 patients is in sharp contrast to that observed in "essential" systemic arterial hypertension or renal hypertension in man; the hypertension observed in the upper arterial compartment should be explained on the basis of mechanical factors and local regulatory mechanisms rather than a postulated generalized vasoconstrictor influence; evidence for renal ischemia was found in only 1 of 8 patients who were free of congestive heart failure and no hepatic ischemia was seen in the 9 patients in whom hepatic blood flow was measured, despite the presence of subnormal mean pressure levels in the lower systemic arterial compartment. The tendency was toward splanchnic hyperemia; the demonstration of incipient or subclinical heart failure in 2 of 10 patients suggests a possible explanation for some of the discrepancies among previously published reports on isolated hemodynamic features of coarctation of the aorta.