8th March 2024

Management

In adult patients with CoA, transcatheter intervention using covered stents has become the first-choice treatment. The prognosis after CoA repair is generally good, with a >90% 10-year survival rate. It is important to note that CoA repair does not prevent the late recurrence of systemic hypertension. Patients should be reviewed regularly at the clinic and arterial hypertension should be treated according to the 2018 ESC guidelines. Echocardiography should be performed periodically for structural assessment post-repair.

The indications for intervention include radiological evidence of significant collateral flow; heart failure and systemic hypertension secondary to CoA, CoA with ≥50% narrowing relative to the aortic diameter and where the CoA gradient >20mmHg in hypertensive patients. 

Antibiotic prophylaxis is not recommended in CoA except for the first 6 months after stenting of CoA or if there has been a history of infective endocarditis.