Coarctation: A Review

Abstract

Coarctation of the aorta occurs in 0.04% of the population, and accounts for approximately 10% of lesions in adults with congenital heart disease. It can occur as an isolated lesion or as a part of a complex defect, and is most commonly associated with bicuspid aortic valve, ventricular septal defect, and mitral valve abnormalities. Since the first surgical repair in 1944, the available treatment options have expanded greatly. Perhaps one of the most important advances in the management of coarctation of the aorta has been the development of transcatheter therapy for both native and especially recurrent coarctation of the aorta. Late complications, even after apparently successful treatment, are not uncommon. For this reason, lifelong follow-up is vital.

Percutaneous Treatment of Aortic Coarctation in Young Adult Supported by Novel Fusion Imaging Technology

“…It can present as a localized stenosis, or as a long, hypoplastic tract of the aorta, other than as an aortic arch interruption [4,5]. Typically, CoA is located near the ductal remnant and left subclavian artery [6]; unusually it occurs at the ascending aorta or abdominal aorta [7]. When the lesion is a discrete stenosis, it consists of a shelf in the posterolateral aortic wall opposite the (remnant of the) ductus arteriosus [5].…”

“…Older patients may show symptoms such as headache, dizziness, tinnitus, abdominal angina, and exertional leg fatigue. The most common presenting finding is systemic hypertension [7]. In adult patients, differential diagnosis includes other causes of secondary arterial hypertension, possibly leading to hypertensive cardiomyopathy.…”

“…In adult patients, differential diagnosis includes other causes of secondary arterial hypertension, possibly leading to hypertensive cardiomyopathy. CoA patients have a life expectancy of 35 years without treatment [7,9], but treated ones have a shorter life expectancy too. Nowadays, patients who reach adolescence can survive up to 40 years after the initial repair if an adult CHD specialized center follow them up [10].…”

“…Nowadays, patients who reach adolescence can survive up to 40 years after the initial repair if an adult CHD specialized center follow them up [10]. Close lifelong follow-up is mandatory, because of the important cardiovascular morbidity related to re-coarctation, descending aortic aneurysm, hypertension, and the other associated CHD [7,8,10]. First surgical repair happened in 1944 [11], then in 1983, Lock et al performed the first percutaneous balloon angioplasty [12].…”

Coarctation of the aorta in a young female treated with left subclavian artery to descending thoracic aorta bypass: a case report

“…Milder cases and those with patent ductus arteriosus can remain asymptomatic until adulthood, accounting for nearly 10% of adult patients with congenital heart disease. 2 Upper extremity hypertension is the most common clinical presentation in adulthood, others being claudication, aortic aneurysm or dissection, and cerebrovascular disease. 3 Here, we present a case of coarctation of the aorta in a young female who presented with hypertension and in whom a left subclavian artery to descending thoracic aorta bypass was done using 12mm tubular polyester graft.…”