David Tanous1, Lee N Benson, Eric M Horlick. 1. Toronto Congenital Cardiac Centre for Adults, University Health Network/Toronto General Hospital, Canada.
Abstract
PURPOSE OF REVIEW: Coarctation of the aorta is the discrete narrowing of the proximal descending aorta and is the sixth most common lesion in congenital heart disease. Repair of the coarctation can relieve the obstruction, but recurrent coarctation and future aneurysm formation can occur, and a heightened risk of vascular disease is present. This review focuses on advances in the management of native and previously treated coarctation and provides insights into future vascular risk. RECENT FINDINGS: Coarctation of the aorta is associated with other left heart obstructive lesions, and advances in the genetic basis of these conditions have been made. Recurrent coarctation and aneurysm formation are common after surgical and endovascular repair of coarctation of the aorta. Endovascular treatment is an acceptable alternative to surgical repair of native and recurrent coarctation. Covered stents and stent grafts can be used to treat arch complications with a low risk of complications. In spite of repair of the obstruction, hypertension persists and appears to be multifactorial due to a variety of factors, including endothelial dysfunction, aortic stiffness, altered arch morphology and increased ventricular stiffness. SUMMARY: People with previously repaired coarctation of the aorta require long-term surveillance for local complications with aortic imaging and surveillance and management of hypertension to prevent vascular disease.
PURPOSE OF REVIEW: Coarctation of the aorta is the discrete narrowing of the proximal descending aorta and is the sixth most common lesion in congenital heart disease. Repair of the coarctation can relieve the obstruction, but recurrent coarctation and future aneurysm formation can occur, and a heightened risk of vascular disease is present. This review focuses on advances in the management of native and previously treated coarctation and provides insights into future vascular risk. RECENT FINDINGS:Coarctation of the aorta is associated with other left heart obstructive lesions, and advances in the genetic basis of these conditions have been made. Recurrent coarctation and aneurysm formation are common after surgical and endovascular repair of coarctation of the aorta. Endovascular treatment is an acceptable alternative to surgical repair of native and recurrent coarctation. Covered stents and stent grafts can be used to treat arch complications with a low risk of complications. In spite of repair of the obstruction, hypertension persists and appears to be multifactorial due to a variety of factors, including endothelial dysfunction, aortic stiffness, altered arch morphology and increased ventricular stiffness. SUMMARY:People with previously repaired coarctation of the aorta require long-term surveillance for local complications with aortic imaging and surveillance and management of hypertension to prevent vascular disease.
Authors: Carmen Turowski; Michelle R Downes; Deirdre M Devaney; Veronica Donoghue; John Gillick Journal: Pediatr Surg Int Date: 2010-06-08 Impact factor: 1.827
Authors: Elise R Pfaltzgraff; Elaine L Shelton; Cristi L Galindo; Brian L Nelms; Christopher W Hooper; Stanley D Poole; Patricia A Labosky; David M Bader; Jeff Reese Journal: J Mol Cell Cardiol Date: 2014-02-04 Impact factor: 5.000
Authors: Carlos A Jesus; Jorge E Assef; Simone R F F Pedra; Waldinai P Ferreira; Tathiane A Davoglio; Ana Cláudia G P Petisco; Mohamed H Saleh; David C S Le Bihan; Rodrigo B M Barretto; Carlos A C Pedra Journal: Int J Cardiovasc Imaging Date: 2016-01-02 Impact factor: 2.357
Authors: Anitra Romfh; Francesca Romana Pluchinotta; Prashob Porayette; Anne Marie Valente; Stephen P Sanders Journal: J Clin Exp Cardiolog Date: 2012-06-15