Preoperative Physiology, Imaging, and Management of Coarctation of Aorta in Children.
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.
['Ganigara|Madhusudan|M|', 'Doshi|Arpan|A|https://orcid.org/0000-0002-7616-1340', 'Naimi|Iman|I|', 'Mahadevaiah|Guru Prasad|GP|', 'Buddhe|Sujatha|S|', 'Chikkabyrappa|Sathish M|SM|https://orcid.org/0000-0003-3747-1490']
D000367:Age Factors D000800:Angioplasty, Balloon D001017:Aortic Coarctation D002648:Child D002675:Child, Preschool D004452:Echocardiography D006801:Humans D007223:Infant D007231:Infant, Newborn D008279:Magnetic Resonance Imaging D015607:Stents D014057:Tomography, X-Ray Computed
coarctation of aorta systemic hypertension congenital heart disease