What is the prognosis of coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Coarctation of the aorta is a lifelong disease with a guarded prognosis. Relief of obstruction, control of hypertension, follow-up monitoring for recurrent obstruction, and follow-up care of associated anomalies are imperative.

Continue subacute bacterial endocarditis prophylaxis indefinitely, even in the absence of associated abnormalities. Patients without residual obstruction who are normotensive both at rest and with exercise should lead normally active lives without restriction. They should be able to obtain health and life insurance.

Patients with persistent hypertension, untreated residual obstruction, or other complications have a variable prognosis related to the severity of these problems.

Data regarding long-term follow-up are limited. Available studies indicate that significant mortality rates are found at long-term follow-up after surgical correction of aortic coarctation. [16] The survival curve, while not approaching that in the healthy population, is significantly improved compared with Campbell's natural history data. [17] Death appears to be secondary to recoarctation repair, aneurysms at site of coarctation repair or at a remote site, congestive heart failure, bacterial endocarditis, and hypertension. Attempts to define factors that affect long-term survival have been made; age at operation and degree and duration of hypertension prior to surgery appear to affect the long-term survival.


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