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Q J Med 1999; 92: 365-371
© 1999 Association of Physicians

Review

Coarctation of the aorta: natural history and outcome after surgical treatment

N.P. Jenkins and C. Ward

From the University Department of Cardiology, Regional Cardiac Centre, Wythenshawe Hospital, Manchester, UK

Dr N.P. Jenkins, Department of Cardiology, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT


   Introduction
 
Coarctation of the aorta (Figure 1Go) accounts for approximately 5% of all congenital heart disease and is found at necropsy in up to 1:1550 patients.1 It is approximately three times more common in males.2 The traditional classification into infantile (preductal) and adult (postductal) types is now regarded as too simplistic, since many patients with preductal lesions do not present until adulthood.3 A spectrum of lesions is now recognized, and it is only those with the most severe obstruction (e.g. aortic arch atresia or interruption) or associated cardiac defects who invariably present in infancy. Most other cases are now identified at routine medical examination. Otherwise, age at presentation is related to the severity rather than the site of obstruction, as a result of cardiac failure or occasionally cerebrovascular accident (CVA), aortic dissection, or endocarditis.



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  		Figure 1. Chest radiograph demonstrating severe rib notching, prominence of the left subclavian artery, and cardiomegaly . . . [Full Text of this Article]

 

   Natural history of aortic coarctation
 

   Surgical and interventional treatment
 

   Results of surgery
 

   Late post-operative mortality
 

   Post-operative hypertension
 

   Coronary artery disease
 

   Cerebrovascular complications
 

   Aortic complications
 

   Recoarctation
 

   Aneurysm formation and aortic rupture
 

   Infective endarteritis
 

   Bicuspid aortic valve disease
 

   Recommendations for post-operative follow-up
 

   References
 

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