Coarctation of the Aorta

Abstract

Coarctation of the aorta is a congenital vascular abnormality, which results in upper body hypertension. Long-term follow-up of patients with previous coarctectomy reveals the presence of adult hypertension in up to 75% of patients 20-30 years after surgery. Of these patients, about 3-26% have a recurrence of the coarctation, but the remaining patients appear to have developed hypertension despite the anatomical repair. Prenatal diagnosis is now possible, and once detected, early repair must be considered. The optimal time for elective surgical repair is about 1 year of age. If patients show symptoms after the age of 1 year, repair should be considered immediately to improve long-term prognosis. The patients also are at risk of accelerated coronary artery disease and cerebrovascular accident. Strict control of blood pressure along with appropriate reduction of other cardiovascular and cerebrovascular risks should minimize subsequent morbidity and mortality. Patients should be evaluated for the presence of other cardiac malformations.