Long-term outcomes in coarctation of the aorta: an evolving story of success and new challenges

摘要

Individuals with coarctation of the aorta have historically had poor long-term outcomes with a mean life expectancy of 35 years. Natural history studies demonstrated 90% of individuals dying before age 50 years. Over the past several decades, improvements in prenatal diagnosis, paediatric cardiac surgery, intensive care and adult congenital care have led to a robust success story with the majority of adults living to older ages. The Heart article by Choudhary et al studies the modern day adult coarctation population and defines a new trajectory for longevity. Although reintervention appears to be inevitable in many cases, with late complications including recoarc-tation, aneurysm development and cardiovascular death, the overall population demonstrates improved outcomes in those who reach adolescence with very good long-term survival to age 60 years.