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Are patients who have had a coarctation of the aorta repaired getting a raw deal? Lifelong follow up is important because of the risks of hypertension, aortic aneurysm, coronary disease, aortic valve problems, and cerebral aneurysm. In Norwich (
) a search for patients with repaired coarctation revealed 53 patients attending either adult cardiology clinics (four patients) or an adult congenital heart disease clinic (49). Twenty-two of them had had a period of at least 2 years without any cardiology follow up before being referred. Sixteen patients had been discharged from cardiology clinics, some quite recently. The message for paediatricians is simple: never discharge a child who has had a coarctation repaired from a paediatric cardiology clinic and arrange transfer to a suitable adult cardiology clinic at the appropriate time (by implication, not all adult cardiology clinics may be regarded as suitable). Special attention will be needed before and during pregnancies.
Data from two UK sources, the Avon Longitudinal Study of Parents and Children (
) and the General Practice Research Database (ibid: 584-91), have given no support to the suggestion that thiomersal in vaccines is a cause of neurodevelopmental disorders in children. A systematic review (ibid: 793–804) also produced no evidence of …