Abstract
Coarctation of the aorta (C) is the sixth most common lesion in congenital heart disease and represents a spectrum of aortic narrowing that varies from a discrete entity to tubular hypoplasia. This condition was once thought to be a relatively simple lesion that would be “cured” upon repair of the narrowing, however, despite relief of the anatomical obstruction the subsequent risk of early morbidity and death persists. This review outlines the optimal management strategy of this disease from neonatal to adult life and provides insights to approach this straightforward but challenging condition.
Highlights
Coarctation of the aorta (C) is the sixth most common congenital lesion accounting for 4–6 per cent of live births with congenital heart disease[1,2]
Most patients have a discrete narrowing of the thoracic aorta at the insertion of the ductus arteriosus, the anatomical spectrum may vary from this discrete entity to tubular hypoplasia, with many variations in between these extremes
Procedural steps At our institution, all procedures that involve balloon angioplasty or stent implantation for C are performed under general anesthesia because pain at the dilatation site and patient movement may compromise the success of the procedure
Summary
Coarctation of the aorta (C) is the sixth most common congenital lesion accounting for 4–6 per cent of live births with congenital heart disease[1,2]. Recurrent coarctation and future aneurysm formation can occur following successful surgical and endovascular repair which mandates long-term close surveillance. It is seen primarily in children due to inadequate aortic wall growth at the site of repair as surgery was performed before the aorta has reached adult size. Recoarctation is an important long-term complication resulting due to inadequate aortic wall growth at the site of repair when surgery is performed before the aorta has reached adult size.
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