How is recurrent coarctation of the aorta (CoA) characterized?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Recurrence of coarctation is associated with patient size, age at surgery, and associated transverse arch or isthmic hypoplasia. Ductal tissue in the wall of the aorta may involute and contribute to recurrence, as might scarring at the repair site. Some surgeons believe that the use of interrupted sutures in the anterior portion of the anastomotic suture line improves aortic growth and reduces the risk of recurrence. Sometimes, the surgical repair site is unobstructed, yet obstruction develops at the transverse arch or isthmus because of the failure of these areas to grow proportionally to the rest of the arch. Such obstruction may not be detected for many years after initial repair.

Some patients who have undergone initial repair with left subclavian flap aortoplasty may have a tortuosity at the repair site that does not result in obstruction until rapid growth in adolescence.

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