Long term follow up of patients with repaired aortic coarctations

Patients with previously repaired coarctation have a significantly reduced life expectancy and continue to be at risk of major complications throughout life including hypertension, aortic aneurysms, premature coronary artery disease, aortic valve problems, and cerebral aneurysms. 1, 2 In addition female patients are at particular risk during pregnancy and childbirth. 3 All patients with previously repaired aortic coarctation require careful life long follow up. 2, 4 Without follow up they may present too late with untreated hypertension or with catastrophic complications such as aortic dissection. Cardiologists who do not specialise in congenital heart disease should either refer their patients on to other cardiologists with an interest in the long term management of aortic coarctation or, if this is not feasible, they should work with them to devise protocol driven care pathways paying particular attention to monitoring of repair sites and aortic valve disease, pre- and peri-pregnancy counselling and care, and aggressive monitoring and control of blood pressure and other risk factors for ischaemic heart disease.