Abstract
Coarctation of the aorta is a common congenital lesion that may often be repaired or intervened upon early in life. The management of patients with this disorder revolves around the concept that although the coarctation may be treated, what remains is a diffuse systemic cardiovascular disorder. Careful clinical care and investigation is required to reduce morbidity from recurrent disease and residual lesions. The natural and modified history of the disorder is reviewed. This article focuses on the clinical care of adults with repaired coarctation and includes a review of clinical goals and investigation as well as indications for reintervention.
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References and Recommended Reading
Christensen NA:Coarctation of the aorta: historical review.Mayo Clin Proc 1948,23:322.
Anderson RH, Macartney FJ, Shinebourne EA, Tynan M:Paediatric Cardiology. Edinburgh: Churchill Livingstone; 1981:1087–1121.
Crafoord C, Nylin G:Congenital coarctation of the aorta and its surgical treatment.J Thorac Surg 1945,14:347.
Blalock A, Park EA:Surgical treatment of experimental (atresia) of aorta.Ann Surg 1944,119:445.
Gross RE, Hufnagel CA:Coarctation of the aorta. Experimental studies regarding its surgical correction.N Engl J Med 1945,233:287.
Singer MI, Rowen M, Dorsey TJ:Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn.Am Heart J 1982,103:131–132.
Ovaert C, Benson LN, Nykanen D, Freedom RM:Transcatheter treatment of coarctation of the aorta: a review.Pediatr Cardiol 1998,19:27–44.
Keith JD:Coarctation of the aorta. InHeart Disease in Infancy and Childhood. Edited by Keith JD, Rowe RD, Vlad P. New York: MacMillan; 1978:736–757.
Keith JD:Prevalence, incidence and epidemiology. InHeart Disease in Infancy and Childhood. Edited by Keith JD, Rowe RD, Vlad P. New York: MacMillan; 1978:3–13.
Izukawa T, Mulholland HC, Rowe RD:Structural heart disease in the newborn.Archives Dis Child 1979,54:281–285.
Reifenstein GH, Levine SA, Gross RE:Coarctation of the aorta. A review of 104 autopsied cases of the adult type 2 years of age or older.Am Heart J 1947,33:146–168.
Ewert P, Abdul-Khaliq H, Peters B, et al.:Transcatheter therapy of long subatretic aortic coarctations with covered stents.Catheter Cardiovasc Interv 2004,63:236–239.
Winer HE, Kronzon I, Glassman E, et al.:Pseudoco-arctation and mid-arch aortic coarctation.Chest 1977,72:519–521.
Edwards JE, Christensen NA, Clagett OT, McDonald JR:Pathological considerations in coarctation of the aorta.Proc Staff Meet Mayo Clin 1948,23:324–332.
Ho SY, Somerville J, Yip WCL, Anderson RH:Transluminal balloon dilation of resected coarcted segments of thoracic aorta: histological study and clinical implications.Int J Cardiol 1988,19:99–105.
Isner JM, Donaldson RF, Fulton D, et al.:Cystic medial necrosis in coarctation of the aorta: a potential factor contributing to adverse consequences observed after percutaneous balloon angioplasty of coarctation sites.Circulation 1987,75:689–695.
Lindsay J Jr:Coarctation of the aorta, bicuspid aortic valve and abnormal ascending aortic wall.Am J Cardiol 1988,61:182–184.
Becker AE, Becker MJ, Edwards JE:Anomalies associated with coarctation of the aorta.Circulation 1970,41:1067–1075.
Waltham, M, Agrawal V, Bowman L:Right arm ischemia following intentional stent graft coverage of an anomalous right subclavian artery.J Endovasc Ther 2005,12:110–114.
Campbell M:Incidence of cardiac malformations at birth and later, and neonatal mortality.Br Heart J 1973,35:189–200.
Cohen M, Fuster V, Steele PM. et al.:Coarctation of the aorta, long-term follow up and prediction of outcome after surgical correction.Circulation 1989,80:840–845.
Toro-Salazar OH, Steinberger J, Thomas W, et al.:Long-term follow up of patients after coarctation of the aorta repair.Am J Cardiol 2002,89:541–547.
Maron BJ, Humphries JO, Rowe RD, Mellits ED et al.:Prognosis of surgically corrected coarctation of the aorta: a 20 year postoperative appraisal.Circulation 1973,47:119–126.
Bjork VO, Bergdahl L, Jonasson R:Coarctation of the aorta. The world’s longest follow-up.Adv Cardiol 1978,22:205–215.
Clarkson PM, Nicholson MR, Barratt-Boyes BG, et al.:Results after repair of coarctation of the aorta beyond infancy: a 10 to 28 year follow-up with particular reference to late systemic hypertension.Am J Cardiol 1983,51:1481–1488.
Rao PS, Chopra PS:Role of balloon angioplasty in the treatment of aortic coarctation.Ann Thorac Surg 1991,52:621–631.
Rao PS:Balloon angioplasty of native aortic coarctation. InTranscatheter Therapy in Pediatric Cardiology. Edited by Rao PS. New York: Wiley-Liss; 1993:153–196.
Pinzon JL, Burrows PE, Benson LN, et al.:Repair of coarctation of the aorta in children: postoperative morphology.Radiology 1991,180:199–203.
Vriend JWJ, Mulder BJM:Late complications in patients after repair of aortic coarctation: implications for management.Int J Cardiol 2005,101:399–406.
Hoimyr H, Christensen TD, Emmertsen K, et al.:Surgical repair of coarctation of the aorta: up to 40 years of follow-up.Eur J Cardiothorac Surg 2006,30:910–916.
Lock JE, Castaneda-Zuniga WR, Bass JL, et al.:Balloon dilatation of excised aortic coarctations.Radiology 1982,143:689–691.
Lock JE, Niemi T, Burke BA, et al.:Transcutaneous angioplasty of experimental aortic coarctation.Circulation 1982,66:1280–1286.
McCrindle BW, Jones TK, Morrow WR, et al.:Acute results of balloon angioplasty of native coarctation versus recurrent aortic obstruction are equivalent.J Am Coll Cardiol 1996,28:1810–1817.
Cowley CG, Orsmond GS, Feola P, et al.:Long-term, randomized comparison of balloon angioplasty and surgery for native coarctation of the aorta in childhood.Circulation 2005,111:3453–3456.
Harrison D, McLaughlin PR, Lazzam C, et al.:Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: one-year follow-up.Heart 2001,85:561–566.
Suarez de Lezo J, Pan M, Romero M, et al.:Immediate and follow-up findings after stent treatment for severe coarctation of aorta.Am J Cardiol 1999,83:400–406.
Hamdan MA, Maheshwari S, Fahey JT, Hellenbrand WE:Endovascular stents for coarctation of the aorta: initial results and intermediate-term follow-up.J Am Coll Cardiol 2001,38:1518–1532.
Magee AG, Brzezinska-Rajszys G, Qureshi SA, et al.:Stent implantation for aortic coarctation and recoarctation.Heart 1999,82:600–606.
Marshall AC, Perry SB, Keane JF, Lock JE:Early results and medium-term follow-up of stent implantation for mild residual or recurrent aortic coarctation.Am Heart J 2000,139:1054–1060.
Chessa M, Carrozza M, Butera G, et al.:Results and mid-long-term follow-up of stent implantation for native and recurrent coarctation of the aorta.Eur Heart J 2005,26:2728–2732.
Shah L, Hijazi Z, Sandhu S, et al.:Use of endovascular stents for the treatment of coarctation of the aorta in children and adults: immediate and midterm results.J Invasive Cardiol 2005,17:614–618.
Tzifa A, Ewert P, Brzezinska-Rajszys G, et al.:Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results.J Am Coll Cardiol 2006,47:1457–1463.
Of major importance Carr JA:The results of catheter-based therapy compared with surgical repair of adult aortic coarctation.J Am Coll Cardiol 2006,47:1101–1107. A recent review comparing surgical and medical therapies. Although heavily biased toward a surgical approach this is a well-written paper and recent review.
Leandro J, Smallhorn JF, Benson L, et al.:Ambulatory blood pressure monitoring and left ventricular mass and function after successful surgical repair of coarctation of the aorta.J Am Coll Cardiol 1992,20:197–204.
Leandro J, Balfe JW, Smallhorn JF, Benson L:Coarctation of the aorta and hypertension.Child Nephrol Urol 1992,12:124–127.
Therrien J, Thorne SA, Wright A, et al.:Repaired coarctation: a cost effective approach to identify complications in adults.J Am Coll Cardiol 2000,35:997–1002.
Of importance Pickering TG, Shimbo D, Haas D:Ambulatory blood pressure monitoring.N Engl J Med 2006,354:2368–2374. An excellent review of the subject and worth reading for practicing cardiologists who treat patients with hypertension.
Swan L, Goyal S, Hsia C, et al.:Exercise systolic blood pressures are of questionable value in the assessment of the adult with a previous coarctation repair.Heart 2003,89:189–192.
Rothman A:Coarctation of the aorta: an update.Curr Probl Pediatr 1998,28:33–60.
Oliver JM, Gallego P, Gonzalez A, et al.:Risk factors for aortic complications in adults with coarctation of aorta.J Am Coll Cardiol 2004,44:1641–1647.
Vriend JWJ, Drenthen W, Pieper PG:Outcome of pregnancy in patients after repair of coarctation.Eur Heart J 2005,26:2173–2178.
Beauchesne LM, Connolly HM, Ammash NM:Coarctation of the aorta: outcome of pregnancy.J Am Coll Cardiol 2001,38:1728–1733.
Plunkett MD, Bond LM, Geiss DM:Staged repair of acute type I aortic dissection and coarctation in pregnancy.Ann Thorac Surg 2000,69:1045–1947.
Abbott ME:Coarctation of the aorta of the adult type. A statistical study and historical retrospect of 200 recorded cases with autopsy of stenosis or obliteration of the descending aorta in subjects over the age of two years.Am Heart J 1928,3:574.
Connolly HM, Huston J III, Brown RD Jr, et al.:Intracranial aneurysms in patients with coarctation of the aorta: a prospective magnetic resonance angiographic study of 100 patients.Mayo Clin Proc 2003,78:1491–1499.
The International Study of Unruptured Intracranial aneurysm investigators:Unruptured intracranial aneurysms-risk of rupture and risk of surgical intervention.N Engl J Med 1999,340:744.
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Horlick, E.M., McLaughlin, P.R. & Benson, L.N. The adult with repaired coarctation of the aorta. Curr Cardiol Rep 9, 323–330 (2007). https://doi.org/10.1007/BF02938381
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DOI: https://doi.org/10.1007/BF02938381