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Isolated Coarctation of the Aorta: Current Concepts and Perspectives

Coarctation of the aorta (CoA), a congenital narrowing of the transverse and proximal descending aortic arch, may present as an isolated defect or in association other CHD and most individuals with isolated CoA now undergo successful catheter-based or surgical therapy and live into adulthood ..

Whereas, surgical management is preferred in the neonate due to lower risk of recoarctation and/or aneurysm formation, isolated CoA presenting later in childhood and adulthood is often amenable to percutaneous intervention.

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Articles of Interest

Coarctation of aorta in adults: a narrative review of surgical and endovascular management

Coarctation of the aorta (CoA) accounts for 5–8% of all congenital heart diseases. Without correction, the mean life expectancy of patients with CoA is 35 years and 90% of those patients die before reaching the age of 50 years. The various treatment options include endovascular, surgery and hybrid procedures.

Coarctation of the aorta

Coarctation of the aorta is an important, treatable cause of secondary hypertension. Its prevalence varies from 5% to 8% of all congenital heart defects. This condition is most often detected because of a murmur or hypertension found on routine examination.

Coarctation of the aorta from fetus to adult: curable condition or life long disease process?

The vast majority of coarctations are identified and treated in the first year of life and adult presentation is becoming less frequent.

Coarctation of the Aorta/Interrupted Aortic Arch

Typically, the narrowed segment occurs where the ductus arteriosus connects to the aorta. The ductus arteriosus is a blood vessel that is present in all newborns. It should shrink and eventually close within the first few days of life. In some cases, the narrowing of the ductus causes the main aorta to also narrow where some of this ductal tissue has extended to the aorta, creating a coarctation. If this occurs, newborn babies can become sick. They have feeding problems, fussiness, sweating, paleness and difficulty breathing. Also, it becomes difficult to feel pulses on the baby.

Diagnosis of Coarctation of the Aorta From Infancy to Adulthood

although CoA is frequently diagnosed by fetal ultrasound, and occasionally by routine newborn pulse oximetry screening, physical examination continues to play an important role in diagnosis.

Hypertension and coarctation of the aorta: an inevitable consequence of developmental pathophysiology

Patients with coarctation of the aorta develop early onset hypertension in spite of early effective repair. This is associated with significant morbidity and is arguably the single most important outcome variable in this patient group.

Resources

CDC

Coarctation of the aorta is usually diagnosed after the baby is born. How early in life the defect is diagnosed usually depends on how mild or severe the symptoms are.

StatPearls

Coarctation of the aorta is a narrowing of the aorta, most commonly occurring just beyond the left subclavian artery. However, it can occur in various other locations of the aortic arch or even in the thoracic or abdominal aorta.

WikEM

Associated with bicuspid aortic valve (50%), VSD, PDA. Neonate in Shock (duct-dependent lesion) - PGE1 0.1mcg/kg/min IV/IO.