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Isolated coarctation of the aorta in the fetus: A diagnostic challenge

Joshua A Kailin1, Alexia B Santos1, Betul Yilmaz Furtun1

  • 1Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Echocardiography (Mount Kisco, N.Y.)
|December 30, 2017
PubMed

Insights

Prenatal diagnosis of coarctation of the aorta (CoA) is crucial for improving infant survival. This review details antenatal aortic arch evaluation, red flags for CoA, and perinatal management strategies.

Area of Science:

  • Cardiology
  • Fetal Medicine
  • Pediatric Surgery

Background:

  • Coarctation of the aorta (CoA) is a significant congenital heart defect (CHD), affecting 4%-6% of cases in the US.
  • Prenatal detection of isolated CoA is vital for improving neonatal outcomes and reducing morbidity.
  • Despite advances in fetal echocardiography, isolated CoA can be missed prenatally, posing risks upon closure of the patent ductus arteriosus (PDA).

Purpose of the Study:

  • To review current methods for antenatal aortic arch evaluation.
  • To identify "red flags" and associated anomalies suggestive of CoA.
  • To provide updated information on in utero diagnosis and perinatal management of CoA.

Main Methods:

  • Comprehensive review of current literature on fetal echocardiography and aortic arch assessment.
  • Analysis of diagnostic criteria and imaging techniques for prenatal CoA detection.
  • Synthesis of information on perinatal care protocols for neonates with suspected or confirmed CoA.

Main Results:

  • Detailed evaluation of the aortic arch is essential during fetal echocardiograms.
  • Specific imaging "red flags" and associated anomalies can increase suspicion for CoA.
  • Timely diagnosis and appropriate perinatal management significantly impact neonatal survival and morbidity.

Conclusions:

  • Antenatal diagnosis of isolated CoA remains challenging but is critical.
  • Adherence to standardized imaging protocols and awareness of "red flags" improve detection rates.
  • Multidisciplinary perinatal management is key for optimizing outcomes in infants with CoA.

Keywords:
aorta coarctationechocardiographyfetal echocardiography

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