Assessment of the Cerebral Circulation in Adults with Coarctation of the Aorta

Abstract

Prospective screening of adults with CoA confirmed the increased prevalence of IA but also identified increased age as the sole risk factor. These data suggested that screening is justified particularly in the fourth and fifth decades of life. Further studies are required that focus on the development, natural history, and treatment of IA.

Frequency of Intracranial Aneurysms Determined by Magnetic Resonance Angiography in Children (Mean Age 16) Having Operative or Endovascular Treatment of Coarctation of the Aorta (Mean Age 3)

“…18e21 Indeed, cardiac muscular arteries, aortic arch, and cervicocephalic arteries all originate from the neural ridge tissue, and the association between cardiac pathologies and IAs has been explained as a developmental abnormality of the neural ridge. 3,9,22,23 Although this relation between CofA and IAs has been suggested by several reports in the literature, most of them were potentially biased by confounding factors. The largest prospective study by Connolly et al 1 enrolled only adult patients, considerably older than ours (mean age No studies have evaluated so far a population of patients early treated in life to establish whether vascular abnormalities are truly developmental or acquired later because of multiple risk factors (hypertension, smoking and alcohol habit, lifestyle, etc.).…”

Risk of Systemic Hypertension and Cerebrovascular Accident in Patients With Aortic Coarctation Aged <60 Years (from a National Database Study)

“…In prior CHD case reports, intracranial aneurysms or the presenting CVA are mostly described in patients with CoA, and sometimes in patients with cyanotic CHD, such as truncus arteriosus, transposition of great arteries. [8][9][10][11][12][13][22][23][24] The embryological basis for such association between CoA (or other CHD) and intracranial aneurysm remains unclear. Besides, we also found that age was a risk factor for CVA in the whole CHD cohort.…”

“…10 By prospective CT angiographic evaluation, intracranial aneurysm was noted in 11% out of 43 adult CoA patients. 8 CoA patients may even present with aneurysmal cerebral or subarachnoid hemorrhage. [11][12][13] Given all these findings, we may suggest that hypertension in CoA patients, who have systemic arteriopathy, further increases the risk of CVA and should be aggressively controlled.…”

“…5,7 Other than hypertension, CoA patients are also associated with intracranial aneurysms. [8][9][10] A prospective screening of 43 adult CoA patients revealed the presence of intracranial aneurysms in 5 (11%). 9 With coexisting hypertension, these patients might be at a higher risk of intracranial hemorrhage or cerebrovascular accident (CVA) from these aneurysms.…”

Veleszületett szívhibák sebészi kezelése 60 éves kor felett

“…Cyanoticus betegekben a stroke előfordulása 4-14% [9,10]. A stroke a vezető halálok coarctatio aortaes betegekben is, de a magas számban társuló intracranialis aneurysma is jelentősen növeli e betegeknél a neurológi-ai szövődményeket [11,12]. Cerebrovascularis történé-sek magas számban fordulnak még elő ASD, Senningműtött nagyér-transzpozíciós betegeknél "residualis baffle leak" esetén, Fontan-keringésben és mechanikus műbillentyű beültetése után [8].…”