51
4.2.6. Coarctation of the Aorta
COR LOE
Recommendations
Diagnostic
1 B-NR
1. In adults with unrepaired COA, cross-sectional imaging is
recommended to determine COA severity and delineate
anatomy of the thoracic aorta.
1 B-NR
2. In adults with repaired COA, periodic cross-sectional
imaging is recommended to screen for recurrent COA,
aortic root/ascending aorta aneurysms, and vascular
complications related to COA repair (focal aortic aneurysm/
pseudoaneurysms/dissection, and stent fracture).*
1 B-NR
3. In adults with COA, blood pressure measurement at rest in
the upper and lower extremities is recommended as part of
routine clinical assessment to screen for hypertension and
residual/recurrent COA.
2a B-NR
4. In adults with COA, ambulatory blood pressure
measurement is reasonable to diagnose hypertension and
monitor response to antihypertensive therapy.
2a B-NR
5. In adults with COA, exercise testing is reasonable to screen
for exercise-induced hypertension.
2a B-NR
6. In adults with COA who present with exertional symptoms,
evaluation for coronary artery disease is reasonable to guide
management.
2b B-NR
7. In adults with COA, screening for intracranial aneurysms by
brain MR or CT angiography may be considered to guide
management.
erapeutic
1 B-NR
8. In adults with native or repaired COA, surgical or
transcatheter stent therapy is recommended for anatomically
and hemodynamically significant COA to prevent
irreversible LV dysfunction from chronic pressure overload.
†
1 B-NR
9. In adults with native or repaired COA and hypertension
without hemodynamically significant COA, GDMT for
hypertension is recommended to maintain controlled resting
and ambulatory blood pressure.
* See Table 24.
†
See Table 25.
