Abstract
For patients with coarctation of the aorta (CoA), surgical intervention results in an overall survival rate nearly twice that of medical management. Therefore, surgical correction of CoA has traditionally been warranted in the majority of patients, even though open repair entails its own complications. With the advent of endovascular technology, many interventionalists hoped that this approach would decrease the complications associated with open surgical repair of CoA. Nevertheless, there is still an ongoing debate about the merits of traditional open surgery versus endovascular therapy. In this review, we discuss the role of these two approaches for the management of CoA, recoarctation, and coarctation-related aneurysms.
Highlights
Coarctation of the aorta (CoA) has a wide spectrum of manifestations
We propose that most coarctation of the aorta (CoA), recoarctations, and CoA-related aneurysms are best treated with endovascular techniques and that surgery should be reserved for selected cases
In patients with CoA, recoarctation, or a CoA-related aneurysm, open surgical repair is associated with an unnecessary risk of morbidity and mortality
Summary
Coarctation of the aorta (CoA) has a wide spectrum of manifestations. The disease may be diagnosed at an early age in patients with acyanotic heart disease or may be diagnosed incidentally in adults. Because of this variability in presentation, each clinical scenario involving CoA is unique, and definitive management should be tailored individually for each patient. We propose that most CoAs, recoarctations, and CoA-related aneurysms are best treated with endovascular techniques and that surgery should be reserved for selected cases
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