Skip to main content
SpringerLink
Log in

Aortic coarctation

  • Chapter
Congenital Heart Defects

  • 2073 Accesses

Abstract

Aortic coarctation is a congenital narrowing of the aortic lumen, usually situated between the origin of the left subclavian artery proximally and the junction of the aorta and the ductus arteriosus distally. When the coarctation is an isolated finding, the wall of the aorta is pinched in a waist-like fashion, the ascending and descending portions of the arch tending to expand above and below the site of coarctation. The narrowing may consist of an elongated and diffuse tract, proximally to the ductus arteriosus (Fig. 3.13.1), or of a sharp constriction in the area of aortic insertion of the arterial duct, with a diaphragmatic shelf of fibrous tissue protruding into the lumen, often with a pin-hole orifice representing the only communication between the ascending and descending aortic segments (Fig. 3.13.2). Aortic arch hypoplasia of mild or severe degree may also be present (Figs. 3.13.3-3.13.5).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Almeida de Oliveira S, Lisboa LA, Dallan LA, Abreu FCA, Rochitte CE, de Souza JM (2003) Extraanatomic aortic bypass for repair of aortic arch coarctation via sternotomy: midterm clinical and magnetic resonance imaging results. Ann Thorac Surg 76:1962–1966

    Article  Google Scholar 

  • Araoz PA, Reddy GP, Tarnoff H, Roge CL, Higgins CB (2003) MR findings of collateral circulation are more accurate measures of hemodynamic significance than arm-leg blood pressure gradient after repair of coarctation of the aorta. J Magn Reson Imaging 17:177–183

    Article  PubMed  Google Scholar 

  • Augustin N, Kaemmerer H, Porner M, Meinhardt G, Hess J, Lange R (2006) Images in cardiovascular medicine. Giant aortic aneurysm after patch repair of coarctation. Circulation 113:e297–298

    Article  PubMed  Google Scholar 

  • Baum U, Anders K, Ropers D, Noemayr A, Schmid A, Seeliger T, Singer H, Daniel WG, Bautz W, Achenbach S (2005) Multi-slice spiral CT imaging after surgical treatment of aortic coarctation. Eur Radiol 15:353–355

    Article  PubMed  Google Scholar 

  • Becker C, Soppa C, Fink U, Haubner M, Muller-Lisse U, Englmejer KH, Buhlmeyer K, Reiser M (1997) Spiral CT angiography and 3D reconstruction in patients with aortic coarctation. Eur Radiol 7:1473–1477

    Article  PubMed  CAS  Google Scholar 

  • Bogaert J, Kuzo R, Dymarkowski S, Janssen L, Celis I, Budts W, Gewillig M (2000) Follow-up of patients with previous treatment for coarctation of the thoracic aorta: comparison between contrast-enhanced MR angiography and fast spin-echo MR imaging. Eur Radiol 10:1847–1854

    Article  PubMed  CAS  Google Scholar 

  • Cademartiri F, van Geuns RJ, Nieman K, Meijboom E, de Feyter PJ (2004) Images in cardiovascular medicine. Multislice computed tomography for the evaluation and follow-up of stenting of aortic coarctation. Circulation 109:e176

    Article  PubMed  Google Scholar 

  • Cademartiri F, Mollet N, Nieman K, Alfieri O, Krestin GP (2004) Images in cardiovascular medicine. Motion-free ECG-gated 16-row multislice computed tomography in the follow-up of aortic coarctation with three-dimensional volume rendering. Ital Heart J 5:167–168

    PubMed  Google Scholar 

  • Chernoff DM, Derugin N, Rajasinghe HA, Hanley FL, Higgins CB, Gooding CA (1997) Measurement of collateral blood flow in a porcine model of aortic coarctation by velocity-encoded cine MRI. Magn Reson Imaging 7:557–563

    Article  CAS  Google Scholar 

  • Choi BW, Choe KO, Kim YJ (2004) Magnetic resonance angiography of pseudocoarctation. Heart 90:1213

    Article  PubMed  CAS  Google Scholar 

  • Connolly HM, Huston J, Brown RD, Warnes CA, Ammash NM, Tajik AJ (2003) Intracranial aneurysms in patients with coarctation of the aorta: a prospective magnetic resonance angiographic study of 100 patients. Mayo Clin Proc 78:1491–1499

    Article  PubMed  Google Scholar 

  • Corno AF, Marcelletti C (1990) Bypass grafts for complex aortic coarctation: simplified approach. J Thorac Cardiovasc Surg 99:945–946

    PubMed  CAS  Google Scholar 

  • Corno AF, Botta U, Hurni M, Payot M, Sekarski N, Tozzi P, von Segesser LK (2001) Surgery for aortic coarctation: a 30 years experience. Eur J Cardiothorac Surg 20:1202–1206

    Article  PubMed  CAS  Google Scholar 

  • Didier D, Saint-Martin C, Lapierre C, Trindade PT, Lahlaidi N, Vallee JP, Kalangos A, Friedli B, Beghetti M (2006) Coarctation of the aorta: pre-and postoperative evaluation with MRI and MR angiography; correlation with echocardiography and surgery. Int J Cardiovasc Imaging 22:457–475

    Article  PubMed  CAS  Google Scholar 

  • Eichhorn JG, Fink C, Delorme S, Hagl S, Kauczor HU, Ulmer HE (2006) Magnetic resonance blood flow measurements in the follow-up of pediatric patients with aortic coarctation. A re-evaluation. Int J Cardiol 113:291–298

    Google Scholar 

  • Elkington AG, Thorne S, Mohiaddin RH (2003) False aortic aneurysm at site of previous coarctation repair: the role of cardiovascular magnetic resonance. J Cardiovasc Magn Res 5:501–504

    Article  Google Scholar 

  • Fiocca L, Zumbo F, Montenero AS, Tesoro-Tess JD (2004) Magnetic resonance angiography in an adult with aortic coarctation associated with subclavian stenosis. Heart 90:424

    Article  PubMed  CAS  Google Scholar 

  • Frydrychowicz A, Schlensak C, Stalder A, Russe M, Siepe M, Beyersdorf F, Langer M, Hennig J, Markl M (2007) Ascending-descending aortic bypass surgery in aortic arch coarctation: four-dimensional magnetic resonance flow analysis. J Thorac Cardiovasc Surg 133:260–262

    Article  PubMed  Google Scholar 

  • Godart F, Labrot G, Devos P, McFadden E, Rey C, Beregi JP (2002) Coarctation of the aorta: comparison of aortic dimensions between conventional MR imaging, 3D MR angiography, and conventional angiography. Eur Radiol 12:2034–2039

    PubMed  Google Scholar 

  • Goo HW, Park IS, Ko JK, Kim YH, Seo DM, Yun TJ, Park JJ, Yoon CH (2003) CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics 23:S147–165

    Article  PubMed  Google Scholar 

  • Gutberlet M, Hosten N, Vogel M, Abdul-Khaliq H, Ehrenstein T, Amthauer H, Hoffmann T, Teichgraber U, Berger F, Lange P, Felix R (2001) Quantification of morphologic and hemodynamic severity of coarctation of the aorta by magnetic resonance imaging. Cardiol Young 11:512–520

    Article  PubMed  CAS  Google Scholar 

  • Hager A, Kaemmerer H, Leppert A, Prokop M, Blucher S, Stern H, Hess J (2004) Follow-up of adults with coarctation of the aorta: comparison of helical CT and MRI, and impact on assessing diameter changes. Chest 126:1169–1176

    Article  PubMed  Google Scholar 

  • Hager A, Kaemmerer H, Hess J (2005) Comparison of helical CT scanning and MRI in the follow-up of adults with coarctation of the aorta. Chest 127:2296

    Article  PubMed  Google Scholar 

  • Henk CB, Grampp S, Koller J, Schoder M, Frank H, Klaar U, Gomischek G, Mostbeck GH (2002) Elimination of errors caused by first-order aliasing in velocity encoded cine-MR measurements of postoperative jets after aortic coarctation: in vitro and in vivo validation. Eur Radiol 12:1523–1531

    Article  PubMed  Google Scholar 

  • Ho VB, Bakalov VK, Cooley M, Van PL, Hood MN, Burklow TR, Bondy CA (2004) Major vascular anomalies in Turner syndrome: prevalence and magnetic resonance angiographic features. Circulation 110:1694–1700

    Article  PubMed  Google Scholar 

  • Holmqvist C, Stahlberg F, Hanseus K, Hochbergs P, Sandstrom S, Larsson EM, Laurin S (2002) Collateral flow in coarctation of the aorta with magnetic resonance velocity mapping: correlation to morphological imaging of collateral vessels. J Magn Reson Imaging 15:39–46

    Article  PubMed  Google Scholar 

  • Ilyas M, Chu C, Ettles D, Mathew V, Atkin S (2006) Evaluation by magnetic resonance imaging of aortic dilatation and coarctation in adult Turner syndrome patients. Clin Endocrinol (Oxf) 65:154–157

    Article  Google Scholar 

  • Ismat FA, Weinberg PM, Rychik J, Karl TR, Fogel MA (2006) Right aortic arch and coarctation: a rare association. Congenit Heart Dis 1:217–223

    Article  PubMed  Google Scholar 

  • Johnson TR, Goldmuntz E, McDonald-McGinn DM, Zackai EH, Fogel MA (2005) Cardiac magnetic resonance imaging for accurate diagnosis of aortic arch anomalies in patients with 22q11.2 deletion. Am J Cardiol 96:1726–1730

    Article  PubMed  CAS  Google Scholar 

  • Konen E, Merchant N, Provost Y, McLaughlin PR, Crossin J, Paul NS (2004) Coarctation of the aorta before and after correction: the role of cardiovascular MRI. Am J Roentgenol 182:1333–1339

    Google Scholar 

  • Kramer U, Greil G, Damman F, Schick F, Miller S, Fenchel M, Sieverding L, Claussen CD (2004) Clinical implication of parameter-optimized 3D-FISP MR angiography (MRA) in children with aortic coarctation: comparison with catheter angiography. Rofo 176:1458–1465

    PubMed  CAS  Google Scholar 

  • Krueger JJ, Ewert P, Yilmaz S, Gelernter D, Peters B, Pietzner K, Bornstedt A, Schnackenburg B, Abdul-Khaliq H, Fleck E, Nagel E, Berger F, Kuehne T (2006) Magnetic resonance imaging-guided balloon angioplasty of coarctation of the aorta: a pilot study. Circulation 113:1093–1100

    Article  PubMed  Google Scholar 

  • Larsen TH, Taxt AM, Aslaksen A, Segadal L, Norgard G, Roksund OD, Greve G (2003) Magnetic resonance imaging of patients with increased blood pressure and altered blood pressure response to exercise after coarctation repair. Scand Cardiovasc J 37:98–103

    Article  PubMed  Google Scholar 

  • Lembcke A, Dohmen P, Rodenwaldt J, Kopka L, Mews J, Rogalla P (2003) Images in cardiovascular medicine. Recoarctation of the aorta associated with ascending aortic aneurysm demonstrated by ECGgated multislice CT. Circulation 107:e80–81

    Article  PubMed  Google Scholar 

  • Leschka S, Alkadhi H, Wildermuth S (2005) Images in cardiology. Collateral circulation in aortic coarctation shown by 64 channel multislice computed tomography angiography. Heart 91:1422.

    Article  PubMed  CAS  Google Scholar 

  • Masiello P, Santoro G, Franzesi E, De Lillo L, Fittipaldi O, Di Benedetto G (1999) Aortic pseudo-coarctation: spiral volumetric computed tomography imaging. Ann Thorac Surg 68:1421

    Article  PubMed  CAS  Google Scholar 

  • Mulder BJ, van der Wall EE (2006) Optimal imaging protocol for evaluation of aortic coarcta(tion) time for a reappraisal. Int J Cardiovasc Imaging 22:695–697

    Article  PubMed  CAS  Google Scholar 

  • Nielsen JC, Powell AJ, Gauvreau K, Marcus EN, Prakash A, Geva T (2005) Magnetic resonance imaging predictors of coarctation severity. Circulation 111:622–628

    Article  PubMed  Google Scholar 

  • Oshinski JN, Parks WJ, Markou CP, Bergman HL, Larson BE, Ku DN, Mukundan S, Pettigrew RI (1996) Improved measurement of pressure gradients in aortic coarctation by magnetic resonance imaging. J Am Coll Cardiol 28:1818–1826

    Article  PubMed  CAS  Google Scholar 

  • Ou P, Mousseaux E, Celermajer DS, Pedroni E, Vouhe P, Sidi D, Bonnet D (2006) Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg 132: 1105–1111

    Article  PubMed  Google Scholar 

  • Papavero R, Kastler B, Clair C, Litzler J, Delabrousse E, Livolsi A, Schneider P, Site O, Bernard Y (2001) Thoracic aortic coarctation: MRI evaluation and follow-up. J Radiol 82:555–561

    PubMed  CAS  Google Scholar 

  • Pinilla I, Bret M, Cuesta E, Borches D, Oliver JM, Gomez-Leon N (2006) Role of computed tomography and magnetic resonance imaging in aortobronchial fistula diagnosis following aortic coarctation reparative surgery. Report of two cases. J Cardiovasc Surg 47:221–227

    CAS  Google Scholar 

  • Pujadas S, Reddy GP, Weber O, Tan C, Moore P, Higgins CB (2006) Phase contrast MR imaging to measure changes in collateral blood flow after stenting of recurrent aortic coarctation: initial experience. J Magn Reson Imaging 24:72–76

    Article  PubMed  Google Scholar 

  • Quenot JP, Boichot C, Petit A, Falcon-Eicher S, d’Athis P, Bonnet C, Wolf JE, Louis P, Brunotte F (2005) Usefulness of MRI in the follow-up of patients with repaired aortic coarctation and bicuspid aortic valve. Int J Cardiol 103:312–316

    Article  PubMed  Google Scholar 

  • Rakvit A, Meyerrose G, Jenkins LA, Harris J, Sanchez R, Lane Cox S, Kurdi J, Gunder A (2002) Coarctation of the aorta demonstrated by a radionuclide first-pass flow study using tc-99m tetrofosmin. Clin Nucl Med 27:822–823

    Article  PubMed  Google Scholar 

  • Raval AN, Telep JD, Guttman MA, Ozturk C, Jones M, Thompson RB, Wright VJ, Schenke WH, DeSilva R, Aviles RJ, Raman VK, Slack MC, Lederman RJ (2005) Real-time magnetic resonance imagingguided stenting of aortic coarctation with commercially available catheter devices in Swine. Circulation 112:699–706

    Article  PubMed  Google Scholar 

  • Riehle TJ, Oshinski JN, Brummer ME, Favaloro-Sabatier J, Mahle WT, Fyfe DA, Kanter KR, Parks WJ (2006) Velocity-encoded magnetic resonance image assessment of regional aortic flow in coarctation patients. Ann Thorac Surg 81:1002–1007

    Article  PubMed  Google Scholar 

  • Robles P, Olmedilla P, Jimenez JJ (2006) Aneurysm formation following stent implantation for aortic coarctation detected by multidetector computed cardiac tomography. Eur Heart J 27:2774

    Article  PubMed  Google Scholar 

  • Ruiz A, Texier N, Bertrand P, Sirinelli D (2005) Aortic diameter measurements on MRI follow-up of coarctation. J Radiol 86:1705–1709

    Article  PubMed  CAS  Google Scholar 

  • Saeed M, Henk CB, Weber O, Martin A, Wilson M, Shunk K, Saloner D, Higgins CB (2006) Delivery and assessment of endovascular stents to repair aortic coarctation using MR and X-ray imaging. J Magn Reson Imaging 24:371–378

    Article  PubMed  Google Scholar 

  • Salanitri GC (2007) Intercostal artery aneurysm complicating thoracic aortic coarctation: diagnosis with magnetic resonance angiography. Australas Radiol 51:78–82

    Article  PubMed  CAS  Google Scholar 

  • Schaffer GJ, Sorantin E, Groell R, Gamillscheg A, Maier E, Schoellnast H, Fotter R (2000) Helical CT angiography with maximum intensity projection in the assessment of aortic coarctation after surgery. Am J Roentgenol 175:1041–1045

    Google Scholar 

  • Shebani SO, Khan MD, Keal R (2005) Anatomical imaging of severe coarctation in childhood. Cardiol Young 15:666

    Article  PubMed  Google Scholar 

  • Shih MC, Tholpady A, Kramer CM, Sydnor MK, Hagspiel KD (2006) Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. Am J Roentgenol 187:W302–312

    Article  Google Scholar 

  • Smith Maia MM, Cortes TM, Parga JR, De Avila LF, Aiello VD, Barbero-Marcial M, Ebaid M (2004) Evolutional aspects of children and adolescents with surgically corrected aortic coarctation: clinical, echocardiographic, and magnetic resonance image analysis of 113 patients. J Thorac Cardiovasc Surg 127:712–720

    Article  PubMed  Google Scholar 

  • Snider AR, Enderlein MA, Teitel DF, Juster RP (1984) Two-dimensional echocardiographic determination of aortic and pulmonary artery sizes from infancy to adulthood in normal subjects. Am J Cardiol 53:218–224

    Article  PubMed  CAS  Google Scholar 

  • Tanju S, Ustuner E, Erden I, Aytac SK (2007) Right cervical aortic arch and pseudocoarctation of the aorta associated with aneurysms and steal phenomena: US, CTA, and MRA findings. Cardiovasc Intervent Radiol 30:146–149

    Article  PubMed  Google Scholar 

  • Uehara M, Funabashi N, Yasukawa K, Terai M, Komuro I (2007) Coarctation of the descending aorta, patent ductus arteriosus, deficiency of right superior vena cava, and persistent left superior vena cava in a five-month infant demonstrated by multislice computed tomography. Int J Cardiol 122:61–63

    Article  PubMed  Google Scholar 

  • Vriend JW, Lam J, Mulder BJ(2004) Complete aortic arch obstruction: interruption or aortic coarctation? Int J Cardiovasc Imaging 20:393–396

    Article  PubMed  CAS  Google Scholar 

  • Vriend JW, Oosterhof T, Mulder BJ (2005) Noninvasive imaging for the postoperative assessment of aortic coarctation patients. Chest 127:2295

    Article  PubMed  Google Scholar 

  • Yildiz A, Ozturk S, Cagirci G (2006) Images in cardiology. Double coarctation and double grafts: role of computed tomographic angiography in diagnosis of a clinic mistery. Heart 92:581

    Article  PubMed  CAS  Google Scholar 

  • Yoshioka K, Niinuma H, Ogino Y, Muranaka K, Kawazoe K, Ehara S (2006) Three-dimensional demonstration of the collateral circulation to the artery of Adamkiewicz with 16-row multislice computed tomography. Ann Thorac Surg 81:749

    Article  PubMed  Google Scholar 

  • Wald RM, Powell AJ (2006) Simple congenital heart lesions. J Cardiovasc Magn Reson 8:619–631

    Article  PubMed  Google Scholar 

Download references

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Steinkopff Verlag

About this chapter

Cite this chapter

(2009). Aortic coarctation. In: Congenital Heart Defects. Steinkopff. https://doi.org/10.1007/978-3-7985-1719-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-7985-1719-6_14

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1718-9

  • Online ISBN: 978-3-7985-1719-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation