Late Complications After Aortic Coarctation Repair

Area of Science:

• Cardiology
• Vascular Surgery
• Pediatric Cardiology

Background:

• Aortic coarctation (CoA) is a congenital heart defect affecting 5-8% of patients.
• CoA presents a wide spectrum from neonatal heart failure to adult hypertension.
• Often associated with bicuspid aortic valve and other vascular malformations.

Purpose of the Study:

• To review the evolving management strategies for aortic coarctation.
• To highlight the shift from surgical to endovascular repair techniques.
• To emphasize the importance of lifelong surveillance for late complications.

Main Methods:

• Review of historical and current management strategies for CoA.
• Analysis of outcomes associated with surgical and endovascular interventions.
• Discussion of long-term complications and surveillance protocols.

Main Results:

• Management has transitioned from open surgery to endovascular repair, with covered stents being preferred.
• Late complications like post-coarctation aneurysms (up to 50%) and re-coarctation remain significant challenges.
• Individualized, anatomy-tailored approaches integrating various techniques are optimal.

Conclusions:

• Lifelong surveillance is essential for managing CoA patients.
• Key risks include systemic hypertension, aneurysm formation, and re-intervention.
• An integrated approach combining surgical, endovascular, and hybrid techniques improves outcomes.