Cardiovascular Morbidity and Mortality in Adult Patients With Repaired Aortic Coarctation

Area of Science:

• Cardiology
• Congenital Heart Disease
• Adult Congenital Heart Disease

Background:

• Long-term cardiovascular disease burden after coarctation of the aorta (CoA) repair is not well understood.
• Assessing cardiovascular events and mortality in adults with repaired CoA is crucial for clinical management.

Purpose of the Study:

• To determine the incidence and risk factors for cardiovascular events in adults with repaired CoA.
• To compare mortality rates in adults with repaired CoA to the general population.

Main Methods:

• A prospective cohort study included 920 adult patients (≥16 years) with prior CoA repair from the Dutch Congenital Corvitia (CONCOR) registry.
• Cardiovascular events (coronary artery disease, stroke, aortic complications, arrhythmias, heart failure, endocarditis, cardiovascular death) were recorded over a mean follow-up of 9.3 years.
• Mortality was compared to an age- and sex-matched general population cohort.

Main Results:

• 21% of patients experienced at least one cardiovascular event, with aortic complications and arrhythmias being most frequent.
• Older age at initial CoA repair and elevated left ventricular mass index were independent risk factors for cardiovascular events.
• The mortality rate was 3.3 times higher than in the general population.

Conclusions:

• Adults with repaired CoA have a substantial long-term burden of cardiovascular events, particularly aortic complications and arrhythmias.
• Older age at repair and increased left ventricular mass index are key risk factors.
• The significantly higher mortality rate highlights the need for rigorous lifelong follow-up and improved preventive measures.