Coarctation of the Aorta
Keywords:
Pons Varolii; pain; fifth cranial nerve; compression, nerve root; microsurgery.Abstract
Coarctation of the aorta is a congenital heart disease with high rates of morbidity and mortality, which is usually underdiagnosed despite the availability of diagnostic tests. The degree of severity of the clinical manifestations of coarctation of the aorta will depend on the level of obstruction, as well as the presence of cardiac defects and associated extracardiac lesions. In the pediatric population the most used therapeutic modality is surgical correction; while balloon angioplasty and stent placement are less used in this population, since they are associated with a greater risk of restenosis with the subsequent reintervention; these techniques are mostly used in older patients. Despite the success in the repair of coarctation of the aorta, patients should continue a close long-term follow-up, which includes periodic blood pressure measurements, as well as imaging studies that assess the cardiac structure, due to the late onset of associated cardiovascular complications.
References
2. Stout K, Daniels C, Aboulhosn J, Bozkurt B, Broberg C, Colman J et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease. JAAC. 2019;73(12):e83-e188.
3. Nelson W, Kliegman R, St Geme J, Behrman R, Tasker R, Shah S et al. Acyanotic Congenital Heart Disease: Obstructive Lesions. Nelson textbook of pediatrics. Vol 2. 20th ed. Philadelphia: Elsevier; 2016. p.2205-2207.
4. Bigdelian H, Sedighi M. Repair of aortic coarctation in infancy: A 10-year clinical experience. Asian Cardiovasc Thorac Ann. 2016;24(5):1-5.
5. Dijkema E, Leiner T, Grotenhuis H. Diagnosis, imaging and clinical management of aortic coarctation. Heart. 2017;103(15):1148-1154.
6. Juffermans J, Nederend I, van den Boogaard P, ten Harkel A, Hazekamp M, Lamb H et al. The effects of age at correction of aortic coarctation and recurrent obstruction on adolescent patients: MRI evaluation of wall shear stress and pulse wave velocity. Eur Radiol Exp. 2019;3(1):1-2.
7. Feltes T, Bacha E, Beekman R, Cheatham J, Feinstein J, Gomes A et al. Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease. Circulation. 2011;123(22):2607-2635.
8. Eckhauser A, South S, Meyers L, Bleyl S, Botto L. Turner Syndrome in Girls Presenting with Coarctation of the Aorta. J Pediatr. 2015;167(5):1062-1064.
9. Cardoso G, Abecasis M, Anjos R, Marques M, Koukoulis G, Aguiar C et al. Aortic Coarctation Repair in the Adult. J Card Surg. 2014;29(4):512-517.
10. Cronenwett J, Johnston K. Embriology. Rutherford's vascular surgery. 8th ed. Philadelphia: Saunders Elsevier; 2014. p.15-33.
11. Nguyen L, Cook S. Coarctation of the Aorta Strategies for Improving Outcomes. Cardiol Clin. 2015;1-3.
12. O’Brien P, Marshall A. Coarctation of the Aorta. Circulation. 2015;131(9):e363-e365.
13. Cangussú L, Lopes M, Barbosa R. The importance of the early diagnosis of aorta coarctation. Rev Assoc Med Bras. 2019;65(02):240-245.
14. Mitchell M. Aortic Coarctation Repair: How I Teach It. Ann Thorac Surg. 2017;104:377-381.
15. Lannering K, Bartos M, Mellander M. Late Diagnosis of Coarctation Despite Prenatal Ultrasound and Postnatal Pulse Oximetry. Pediatrics. 2015;136(2):e406-e411.
16. Edwards L, Arunamata A, Maskatia S, Quirin A, Bhombal S, Maeda K et al. Fetal Echocardiographic Parameters and Surgical Outcomes in Congenital Left-Sided Cardiac Lesions. Pediatr Cardiol. 2019;40(6):1304-1310.
17. Padalino M, Bagatin C, Bordin G, Tua L, Francescato A, Pradegan N et al. Surgical repair of aortic coarctation in pediatric age: A single center two decades experience. J of Card Surg. 2019;34(5):1-9.
18. Jenkins N. Coarctation of the aorta: natural history and outcome after surgical treatment. Q J Med. 1999;92(7):365-371.
19. Quennelle S, Powell A, Geva T, Prakash A. Persistent Aortic Arch Hypoplasia After Coarctation Treatment Is Associated With Late Systemic Hypertension. J Am Heart Assoc. 2015;4(7):1-6.
20. Hoffman J Kaplan S. The Incidence of Congenital Heart Disease. JACC. 2002;39(12):1890-1893.
Downloads
Published
Issue
Section
License
The intellectual property of accepted works belongs to their authors, however access to them is totally open and free, so they can be reproduced totally or partially with the only limitation of recognizing the authorship and the source of publication (Revista Medicina Legal de Costa Rica), as long as said exploitation does not have commercial character.
