Therapeutic strategies and prognosis in aortic coarctation: a lifelong disease

Aortic coarctation is a common but complex congenital heart condition, characterized by a narrowing of the proximal part of the descending aorta. Despite early surgical correction, the narrowing often recurs at a later age, which is frequently treated by stent implantation. In this thesis, the effectivity of stent implantation is evaluated and strategies for optimization of stent implantation are discussed, including epinephrine stress testing and aortic arch stenting. In the long term, patients with aortic coarctation are at increased risk of hypertension (in rest and/or during exercise) and consequent cardiovascular complications. This thesis provides insight into the occurrence of these complications and associated risk factors. A better understanding of the pathophysiology of cardiovascular morbidity and mortality in this patient population is needed to improve risk prediction and prevention.