Patients with coarctation of the aorta require life-long follow-up with a cardiologist experienced in congenital heart disease.[16]Writing Committee Members, Isselbacher EM, Preventza O, et al. 2022 ACC/AHA Guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 Dec 13;80(24):e223-e393.
https://www.doi.org/10.1016/j.jacc.2022.08.004
http://www.ncbi.nlm.nih.gov/pubmed/36334952?tool=bestpractice.com
[51]de Bono J, Freeman LJ. Aortic coarctation repair - lost and found: the role of local long term specialised care. Int J Cardiol. 2005 Sep 30;104(2):176-83.
http://www.ncbi.nlm.nih.gov/pubmed/16168811?tool=bestpractice.com
While frequency should be individualized to the individual patient's repair and their clinical status, there are published guidelines to guide the frequency of follow-up and testing.[20]Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2019 Apr 2;73(12):e81-192.
https://www.sciencedirect.com/science/article/pii/S0735109718368463
Particular attention should be paid to the potential for ongoing hypertension, recoarctation requiring reintervention, cerebral aneurysm, aortic pseudoaneurysm, and dissection. Neurodevelopmental surveillance and screening is also important when caring for these patients particularly if they had repair in infancy.[52]Sood E, Newburger JW, Anixt JS, et al. Neurodevelopmental outcomes for individuals with congenital heart disease: updates in neuroprotection, risk-stratification, evaluation, and management: a scientific statement from the American Heart Association. Circulation. 2024 Mar 26;149(13):e997-e1022.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001211?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/38385268?tool=bestpractice.com
Upper and lower extremity blood pressures should be measured at every clinic visit.
Periodic echocardiograms (every 1-3 years) should be performed to assess the possibility of recoarctation or aneurysm formation. In older children and adults, echocardiographic windows are often not adequate to fully assess the aortic vasculature. In these cases, follow-up imaging with computed tomography angiography or contrast-enhanced magnetic resonance imaging allows assessment of the aortic vasculature in great detail and facilitates planning for any necessary surgical or catheter-based interventions.[23]Shih MC, Tholpady A, Kramer CM, et al. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. AJR Am J Roentgenol. 2006 Sep;187(3):W302-12.
http://www.ajronline.org/doi/full/10.2214/AJR.05.0424
http://www.ncbi.nlm.nih.gov/pubmed/16928909?tool=bestpractice.com
[47]von KY, Aydin AM, Bernhardt AM, et al. Aortic aneurysms after correction of aortic coarctation: a systematic review. Vasa. 2010;39:3-16.