Recent advances in the diagnosis and treatment of coarctation of the aorta.

Although it has been the topic of intense medical and surgical attention for over 50 years, coarctation of the aorta continues to be a major cause of cardiovascular morbidity and mortality in infants and children. Refinements in established diagnostic modalities--primarily fetal, transesophageal, and intravascular echocardiography--have improved pre- and post-treatment assessments. Aggressive and early intervention, whether by surgery, catheter, or both, have been shown to increase initial success; the results of long-term follow-up are yet to be determined. The best possible outcome requires prompt recognition and effective treatment directed at immediate gradient relief, which will hopefully prevent or reduce the known late and long-term sequelae.