Aortic Coarctation in the Adult

Coarctation of the aorta is one of the more common congenital lesions that may be recognized for the first time in adulthood. Recurrent coarctation of the aorta first treated in childhood is also commonly encountered in the adult age-group. Unrepaired coarctation of the aorta or repaired coarctation with residual stenosis may lead to premature atherosclerotic disease of the carotid and coronary arteries, and early left ventricular systolic and diastolic dysfunction. Significant coarctation or recoarctation of the aorta presenting in adulthood is treated with surgery or with transcatheter stenting. Although serious complications are possible, in general, very good immediate and long-term outcomes are expected after successful intervention though ongoing surveillance is mandatory. Many adult patients with coarctation despite complete or near-complete gradient relief will require lifelong antihypertensive medical therapy and surveillance for early-onset coronary artery disease.