Aortic coarctation: an overview

Abstract

In severe aortic coarctation in the neonatal period, surgical repair is required soon after clinical stabilization. Elective repair of isolated aortic coarctation is nowadays indicated at 3-6 months of life or at the time of diagnosis. At present, no single operation appears to have a clear superiority. However, during the first months of life, an extended end-to-end anastomosis is considered the best option by most authors, even though weight at operation and anatomy of the aortic arch are also significant determinants of late recoarctation. In cases of aortic arch hypoplasia, which occurs in up to 70% of neonatal and infant coarctations, especially when associated anomalies are present, surgery seems the treatment of choice. After 3 months of age and in the adult population, balloon angioplasty and stent placement are considered a suitable option. Recently, we adopted a median sternotomy approach without the use of extracorporeal circulation for the treatment of aortic coarctation with a hypoplastic aortic arch. We treated 11 patients with satisfactory results at an average follow-up of 40 months.

An unexpected finding late after repair of coarctation of the aorta

“…3,4 This malformation occurs up to five times more frequently in males than females and is associated with ventricular septal defect (30 to 45%), bicuspid aortic valve (30 to 85%), patent ductus arteriosus, mitral stenosis and aortic stenosis (valvular, subvalvular, or supravalvular). 5,6 Intracerebral aneurysms and Turner's syndrome are extracardiac defects associated with coarctation of the aorta.…”

“…[8][9][10] Adults with previously undiagnosed CoA can present with severe hypertension and associated symptoms such as headache, heart failure, epistaxis or aortic dissection. 4,11 Physical examination in patients with an asymptomatic CoA may reveal continuous murmurs, as well as palpable pulsations from large collateral vessels. An arm-leg pressure gradient of at least 10 mmHg and diminished femoral pulses may be present.…”

Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation

“…In more severe cases, this may develop into left ventricular hypertrophy [15] and dilatation and outwards remodeling of collateral arteries from the intercostal arteries that branch back into the descending aorta. Treatment of aortic coarctation includes excision of the constricted segment and the subsequent creation of an end-to-end anastomosis, placement of a synthetic patch, or balloon dilatation and stenting [1]. The most important predictor of successful long-term outcome is age at time of initial repair [4], and thus early detection of coarctation.…”

Percutaneous transluminal angioplasty in recurrent necrotizing enterocolitis—a case report

“…Indications include dilatation of pulmonary valve stenosis in tetralogy of Fallot simplifying the surgical management [4], treatment of aortic coarctation [5], and renal artery stenosis to control hypertension [6][7][8].…”