Coarctation of the aorta: From fetal life to adulthood

Kenny, Damien; Hijazi, Ziyad M.

doi:10.5603/cj.2011.0003

Cited by 164 publications

(115 citation statements)

References 70 publications

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“…Coarctation of the aorta is now known to be a lifelong process related to underlying aortopathy and possible vasculopathy. 59,60,65 Even with adequate repair, a significant number of patients remain hypertensive, with the incidence of hypertension directly related to age at repair. Sequelae and associations also include ascending aortic aneurysm, aneurysm at the repair site, and premature CAD.…”

Section: Circulationmentioning

confidence: 99%

“…In patients with coarctation of the aorta, the prevalence of hypertension is higher with later repair. 59,60 Obesity is associated with development of hypertension, insulin resistance, dyslipidemia, sleep apnea, autonomic imbalance, and increased inflammatory cytokines. The prevalence of obesity in the general population has been increasing dramatically, and this trend does not appear to spare the ACHD population.…”

Section: Circulationmentioning

confidence: 99%

See 1 more Smart Citation

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

205

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Section: Circulationmentioning

confidence: 99%

Section: Circulationmentioning

confidence: 99%

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

205

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“…18 The current American Heart Association guidelines state that balloon angioplasty is recommended in children older than 4 to 6 months of age if the gradient exceeds 20 mmHg and the patient's anatomy is suitable. 19,20 It is crucial to keep persistent 5th aortic arch in mind, especially in patients who have coarctation and pulmonary atresia. To our knowledge, our pediatric patient is only the third to have been diagnosed with interrupted 4th arch, coarctation of a persistent 5th arch, and no other intracardiac defects.…”

Section: Discussionmentioning

confidence: 99%

Coarctation of Persistent 5th Aortic Arch: First Report of Catheter-Based Intervention

Uysal¹,

Bostan²,

Çil³

2014

Texas Heart Institute Journal

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P ersistent 5th aortic arch, an apparently rare congenital anomaly, is defined as a single aortic arch with separate superior and inferior parts.1 It was initially called a double-lumen aortic arch.2 The 5th aortic arch forms between the true aortic arch (a derivative of the 4th aortic arch) and the pulmonary artery (a derivative of the 6th aortic arch).3 Without additional coarctation of the existing aorta, this anomaly alone has no physiologic significance and does not necessitate surgical intervention.We report our catheter-based treatment of an infant who had aortic coarctation of a persistent 5th aortic arch with no associated cardiac defects. Case ReportIn July 2012, a 7-month-old infant girl was referred to our department for evaluation of a heart murmur. The healthy-looking patient had a normal prenatal and postnatal history. Her blood pressure was normal, and her systemic oxygen saturation was 98% on room air. Auscultation revealed normal heart sounds and a grade 2/6 midsystolic murmur that was audible at the 3rd left sternal border and at the back. The patient's diminished femoral pulses raised the suspicion of aortic coarctation.Electrocardiographic results were normal. Echocardiograms showed left ventricular hypertrophy and an unusual double-lumen aortic arch. There was coarctation of the inferior part of the arch (Fig. 1), and mild obstruction was evident upon color-flow Doppler analysis. Continuous-wave Doppler images revealed a 50-mmHg peak instantaneous gradient at the coarctation site, with typical diastolic runoff. Conventional angiograms showed that the common origin of all brachiocephalic vessels from the ascending aorta ended after the left subclavian artery. A distinct vessel in the inferior part of the interrupted arch originated from the ascending aorta and connected with the descending aorta (Fig. 2). We concluded that this lower arch was a persistent 5th aortic arch. The definitive diagnosis was interrupted 4th arch with persistent 5th arch. The coarctation was at the distal end of the 5th arch.During catheterization, after consulting a cardiac surgeon, we performed balloon angioplasty to correct the coarctation. Afterwards, the peak-to-peak gradient decreased from 50 to 20 mmHg (Fig. 3). At age 1 year, the patient was normotensive. Echocardiograms revealed mild repeat coarctation at the distal end of the persistent 5th arch and a 30-mmHg peak instantaneous gradient across the coarctation site. As of June 2014, we continue to monitor the patient for hypertension and any increase in the gradient. Surgical intervention might be necessary in the future.

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“…It is estimated to occur in 0.3% of all live births [2]. That is, coarctation of the aorta affects 1:2.500 live births in the USA [3] [4]. It tends to affect males more than females [5].…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic Anomalous Collateral Artery Derived from the Left Internal Thoracic Artery: Established Strong Collateral Circulation

Buchanan

Малахова²

2014

OALib

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An anomalous collateral artery was found during the dissection for the pectoralis major myocutaneous flap procedure. This anomalous collateral artery was stemming from the left internal thoracic artery. It is believed that this collateral was formed secondary to congenital aortic coarctation causing abnormal growth of the left fourth aortic arch. This is the first reported case of such a collateral artery in recent literature.

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Coarctation of the aorta: From fetal life to adulthood

Cited by 164 publications

References 70 publications

Congenital Heart Disease in the Older Adult

Congenital Heart Disease in the Older Adult

Coarctation of Persistent 5th Aortic Arch: First Report of Catheter-Based Intervention

Asymptomatic Anomalous Collateral Artery Derived from the Left Internal Thoracic Artery: Established Strong Collateral Circulation

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