Coarctation of the aorta - an epidemiological review of the Maltese Islands

Abstract

Introduction: Coarctation of the Aorta (CoA) is congenital heart defect resulting in a constriction of the descending aorta. Data including the number of total cases and live births with Coarctation of the Aorta in Malta was obtained from the Congenital Anomaly Register after proper ethical approval. Methods: Data was collected for the period of 1993 to 2015. The total prevalence of CoA was then calculated per 10,000 births in Malta. The data for the prevalence of patients with CoA, in all European Surveillance of Congenital Anomalies (EUROCAT) registered European countries was then obtained for the same period of 1993 to 2015. All prevalence data has a confidence interval of 95%. This was then compared to the prevalence in the Maltese Islands. The comparison was done via two methods, first by working out a European Average which was assessed against the Maltese average, and then by evaluating the total prevalence of each EUROCAT registered country with that of Malta. Results: In the first scenario, it was observed that when compared to the European average of total prevalence, Malta seems to be fluctuating having years with higher and lower prevalence than that of Europe. However, from the trend line, it is evident that the Maltese prevalence has been on the decline and is currently below European average. On the other hand, when assessing the total prevalence of each country, out of the thirty-one registered European countries, Malta is the 10th country when starting from the highest total prevalence, with a value of 4.66. Conclusion: In conclusion, having a high birth prevalence of CoA births does not necessarily mean that the prevalence in Malta is increasing, but rather that having improved diagnostic methods is contributing to the fact that more cases are being diagnosed. Further studies are required to identify any possible environmental factors contributing to the fluctuations in the rate of incidence of this disease. This will ultimately influence the treatment provided and hence the prognosis of this anomly.