Hypertension at diagnosis of coarctation of the aorta as a risk factor for recoarctation.

Background: Coarctation of the aorta (CoA) is a narrowing of the aorta that affects 5-8% of congenital heart defects. Treatment options include surgical repair or transcatheter management with endovascular stenting or balloon dilatation. Late complications after operative repair include systemic hypertension, aortic valve abnormalities, aortic aneurysm, and recoarctation. This study examines the association between the presence of hypertension at the diagnosis of CoA and recoarctation.

Methods: This retrospective study analyzed medical records of patients at Soroka University Medical Center who underwent treatment for CoA between 1978 and 2021. The study included 128 patients diagnosed with CoA and who underwent repair; 9 were excluded, leaving 119 patients for analysis.

Results: Of the 119 patients, 28 developed recoarctation within 15 years of initial repair. Patients with hypertension at initial diagnosis were more likely to develop recoarctation, adjusted to sex and ethnicity. Other patient characteristics were not significantly associated with recoarctation.

Conclusions: Hypertension at the time of initial CoA diagnosis is a risk factor for the development of recoarctation within 15 years of initial repair. Close monitoring and management of blood pressure may be important for patients with CoA. Future research should investigate whether hypertension control can reduce recoarctation risk in this population.

Impact: Previous studies focus on post-repair hypertension in CoA. Limited research on hypertension during CoA diagnosis. Knowledge gap on its impact on recoarctation risk. Hypertension at CoA diagnosis may predict recoarctation. Enables tailored monitoring and timely intervention.