Title

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

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