Isolated Coarctation of the Aorta: Current Concepts and Perspectives

Authors

Ami B. Bhatt, Departments of Internal Medicine and Pediatrics and Division of Cardiology, Harvard Medical School, Boston, MA, United States.
Maria R. Lantin-Hermoso, Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
Curt J. Daniels, Departments of Pediatrics and Internal Medicine, The Ohio State University Medical Center, Columbus, OH, United States.
Robert Jaquiss, Department of Cardiovascular and Thoracic Surgery and Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States.
Benjamin John Landis, Department of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, United States.
Bradley S. Marino, Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, OH, United States.
Rahul H. Rathod, Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
Robert N. Vincent, Department of Pediatrics, New York Medical College, Valhalla, NY, United States.
Bradley B. Keller, Cincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States.
Juan Villafane, Cincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States.

Author Type(s)

Faculty

DOI

10.3389/fcvm.2022.817866

Journal Title

Frontiers in Cardiovascular Medicine

First Page

817866

Document Type

Article

Publication Date

1-1-2022

Department

Pediatrics

Abstract

Current management of isolated CoA, localized narrowing of the aortic arch in the absence of other congenital heart disease, is a success story with improved prenatal diagnosis, high survival and improved understanding of long-term complication. Isolated CoA has heterogenous presentations, complex etiologic mechanisms, and progressive pathophysiologic changes that influence outcome. End-to-end or extended end-to-end anastomosis are the favored surgical approaches for isolated CoA in infants and transcatheter intervention is favored for children and adults. Primary stent placement is the procedure of choice in larger children and adults. Most adults with treated isolated CoA thrive, have normal daily activities, and undergo successful childbirth. Fetal echocardiography is the cornerstone of prenatal counseling and genetic testing is recommended. Advanced 3D imaging identifies aortic complications and myocardial dysfunction and guides individualized therapies including re-intervention. Adult CHD program enrollment is recommended. Longer follow-up data are needed to determine the frequency and severity of aneurysm formation, myocardial dysfunction, and whether childhood lifestyle modifications reduce late-onset complications.

Recommended Citation

Bhatt, A. B., Lantin-Hermoso, M. R., Daniels, C. J., Jaquiss, R., Landis, B. J., Marino, B. S., Rathod, R. H., Vincent, R. N., Keller, B. B., & Villafane, J. (2022). Isolated Coarctation of the Aorta: Current Concepts and Perspectives. Frontiers in Cardiovascular Medicine, 9, 817866. https://doi.org/10.3389/fcvm.2022.817866