Preoperative Physiology, Imaging, and Management of Coarctation of Aorta in Children.
Document Type
Article
Publication Date
12-2019
Identifier
DOI: 10.1177/1089253219873004
Abstract
Coarctation of the aorta (CoA) is a narrowing of the proximal thoracic aorta typically located at the junction of the aorta with the ductus arteriosus. While it is a simple lesion to understand, considerable variation exists in the anatomy and pathophysiology, leading to varied clinical presentation, management options, and prognosis. On the one hand critical CoA manifests in the neonatal period as a duct-dependent lesion, while less severe forms of obstruction present later in childhood or adulthood as hypertension or incidentally noted precordial murmurs. While transthoracic echocardiography is usually adequate, older children and adults may need more advanced imaging modalities like computed tomography and magnetic resonance imaging prior to intervention. Depending on the type of lesion, management options currently available include surgery and percutaneous balloon angioplasty and stenting. Even after successful interventions, these patients need life-long surveillance for residual aortic obstruction and systemic hypertension with variable long-term clinical outcomes.
Journal Title
Seminars in cardiothoracic and vascular anesthesia
Volume
23
Issue
4
First Page
379
Last Page
386
MeSH Keywords
Age Factors; Angioplasty, Balloon; Aortic Coarctation; Child; Child, Preschool; Echocardiography; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Stents; Tomography, X-Ray Computed
Keywords
coarctation of aorta; congenital heart disease; systemic hypertension
Recommended Citation
Ganigara M, Doshi A, Naimi I, Mahadevaiah GP, Buddhe S, Chikkabyrappa SM. Preoperative Physiology, Imaging, and Management of Coarctation of Aorta in Children [published correction appears in Semin Cardiothorac Vasc Anesth. 2021 Mar;25(1):77]. Semin Cardiothorac Vasc Anesth. 2019;23(4):379-386. doi:10.1177/1089253219873004
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