Coarctation of the Aorta: Diagnosis and Management

Abstract

Coarctation of the aorta (CoA) accounts for approximately 5–8% of all congenital heart defects. Depending on the severity of the CoA and the presence of associated cardiac lesions, the clinical presentation and age vary. Developments in diagnosis and management have improved outcomes in this patient population. Even after timely repair, it is important to regularly screen for hypertension. Patients with CoA require lifelong follow-up with a congenital heart disease specialist as these patients may develop recoarctation and complications at the repair site and remain at enhanced cardiovascular risk throughout their lifetime.

Secondary hypertension and aortic coarctation in a young adult: A case report

“…The current evidence does not indicate significant differences between stent, balloon, or surgical treatment modalities in terms of prognostic outcomes, leaving a choice of therapeutic approach open to the vascular team [12] . In the future, the use of advanced imaging techniques like the 4D flow MRI, combining noninvasive anatomical and hemodynamic data, will improve prognosis for these patients [11 , 12] , aiding the vascular surgery team's decision-making process regarding the best approach for optimal outcomes.…”

“…The Angio-MRI was chosen due to its hemodynamic assessment capabilities [10] , allowing the determination of aortic stiffness [11] , which is a key feature for establishing the best treatment plan in this clinical situation and monitoring for the possible adverse hemodynamic consequences of a residual gradient or inadequately controlled hypertension [12] . The current evidence does not indicate significant differences between stent, balloon, or surgical treatment modalities in terms of prognostic outcomes, leaving a choice of therapeutic approach open to the vascular team [12] .…”

“…The Angio-MRI was chosen due to its hemodynamic assessment capabilities [10] , allowing the determination of aortic stiffness [11] , which is a key feature for establishing the best treatment plan in this clinical situation and monitoring for the possible adverse hemodynamic consequences of a residual gradient or inadequately controlled hypertension [12] . The current evidence does not indicate significant differences between stent, balloon, or surgical treatment modalities in terms of prognostic outcomes, leaving a choice of therapeutic approach open to the vascular team [12] . In the future, the use of advanced imaging techniques like the 4D flow MRI, combining noninvasive anatomical and hemodynamic data, will improve prognosis for these patients [11 , 12] , aiding the vascular surgery team's decision-making process regarding the best approach for optimal outcomes.…”

Cardiac Adaptation and Preferential Streaming in Fetuses with Multiple Nuchal Cords

“…Disproportion between the pulmonary artery and the aorta with the Pa/Ao ratio equal to or larger than 1.6 should be an alarming sign of the possible coarctation of the aorta (CoA) [ 8 , 9 , 10 ]. If the ascending aorta has a greater diameter than the main pulmonary artery, it usually does not suggest severe congenital heart disease but requires prenatal and postnatal echocardiographic examinations [ 11 ].…”

Non-Invasive Imaging Assessment in Patients with Aortic Coarctation: A Contemporary Review

“…Coarctation of the aorta (CoA) accounts for 6–8% of congenital heart disease (CHD) and is defined as a narrowing (either discrete or as a long hypoplastic segment) of the aorta, usually at the level of the insertion of the ductus arteriosus [ 1 ]. Traditionally, CoA can also be further classified depending on the relationship with the ductus itself in a pre-ductal (infantile), ductal, or post-ductal (adult) type [ 2 ]. The co-existence of a bicuspid aortic valve (BAV) is frequent and described in up to 85% of CoA cases [ 3 ].…”