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[Coarctation of the aorta and its surgical treatment]

F Tronc1, A Curtil, J Robin

  • 1Service de chirurgie cardiovasculaire et thoracique C, hôpital cardiovasculaire et pneumologique, Lyon-Montchat.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 20, 1998
PubMed

Insights

Coarctation of the aorta, a common congenital heart defect, involves aortic arch obstruction. Surgical correction, ideally between 6-12 months, can be improved with modified techniques to reduce restenosis risks.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Context:

  • Coarctation of the aorta (CoA) is a significant congenital heart malformation, accounting for 5-7.5% of all cases.
  • It presents in two main forms: asymptomatic isolated childhood coarctation and neonatal/infant coarctation often associated with other cardiovascular defects, particularly tubular hypoplasia of the aortic arch.
  • CoA is notably more prevalent in boys, with a 2-3 times higher incidence compared to girls.

Purpose:

  • To define coarctation of the aorta and outline its prevalence and epidemiological characteristics.
  • To distinguish between the clinical presentations of isolated childhood coarctation and neonatal/infant coarctation.
  • To discuss optimal surgical timing and techniques for coarctation of the aorta, including managing associated aortic arch hypoplasia.

Summary:

  • Coarctation of the aorta is an obstruction at the aortic arch-descending aorta junction, a common congenital heart defect (5-7.5%).
  • It is more frequent in boys and presents as either asymptomatic isolated childhood coarctation or neonatal/infant coarctation with associated defects.
  • Surgical correction of isolated coarctation is recommended between 6 months and 1 year to minimize residual hypertension, with modified Crafoord techniques addressing restenosis and hypoplasia.

Impact:

  • Optimal surgical timing for isolated coarctation of the aorta is between 6 months and 1 year to reduce the incidence of residual hypertension.
  • A modified Crafoord technique offers improved outcomes by decreasing the risk of restenosis.
  • This approach also allows for simultaneous treatment of associated tubular hypoplasia of the aortic arch during the primary surgical procedure.

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