Coarctation of the Aorta

  • Bradley J. Harlan
  • Albert Starr
  • Fredic M. Harwin
  • Alain Carpentier


Coarctation of the thoracic aorta was first resected successfully in 1944.20 Although resection has remained the most common method of repair, additional operations have been developed to encompass the anatomic variations of coarctation. The objective of all procedures is permanent relief of any gradient across the coarctation and establishment of normal, pulsatile flow to the lower body.


Aortic Arch Subclavian Artery Ventricular Septal Defect Left Subclavian Artery Aortic Coarctation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abbott ME: Coarctation of the aorta of the adult type. Am Heart J 3:574,1928.CrossRefGoogle Scholar
  2. 2.
    Aert H, Laas J, Bednarski P, Koch U, Prokop M, Borst HG: High incidence of aneurysm formation following patch plasty repair of coarctation. Eur J Cardiothorac Surg 7:200,1993.CrossRefGoogle Scholar
  3. 3.
    Allen HD, Marx GR, Ovitt TW, Goldberg SJ: Balloon dilatation angioplasty for coarctation of the aorta. Am J Cardiol 57:828,1986.PubMedCrossRefGoogle Scholar
  4. 4.
    Arenas JD, Myers JL, Gleason MM, Vennos A, Baylen BG, Waldhausen JA: Endto-end repair of aortic coarctation using absorbable polydioxanone suture. Ann Thorac Surg 51:413,1991.PubMedCrossRefGoogle Scholar
  5. 5.
    Balderston SM, Daberkow E, Clarke DR, Wolfe RR: Maximal voluntary exercise variables in children with postoperative coarctation of the aorta. J Am Coll Cardiol 19:154,1992.PubMedCrossRefGoogle Scholar
  6. 6.
    Beekman RH, Rocchini AP, Behrendt DM, Bove EL, Dick M II, Crowley DC, Snider AR, Rosenthal A: Long-term outcome after repair of coarctation in infancy: subclavian angioplasty does not reduce the need for reoperation. J Am Coll Cardiol 8:1406,1986.PubMedCrossRefGoogle Scholar
  7. 7.
    Beekman RH, Rocchini AP, Dick M II, Snider AR, Crowley DC, Serwer GA, Spicer RL, Rosenthal A: Percutaneous balloon angioplasty for native coarctation of the aorta. J Am Coll Cardiol 10:1078,1987.PubMedCrossRefGoogle Scholar
  8. 8.
    Braimbridge MV, Yen A: Coarctation in the elderly. Circulation 31:209,1965.PubMedGoogle Scholar
  9. 9.
    Brandt B, Marvin WJ, Rose EF, Mahoney LT: Surgical treatment of coarctation of the aorta after balloon angioplasty. J Thorac Cardovasc Surg 94:715,1987.Google Scholar
  10. 10.
    Brewer LA, Fosburg RG, Mulder GA, Verska JJ: Spinal cord complications following surgery for coarctation of the aorta. J Thorac Cardiovasc Surg 64:368,1972.PubMedGoogle Scholar
  11. 11.
    Brom AG: Narrowing of the aortic isthmus and enlargement of the mind. J Thorac Cardiovasc Surg 50:166,1965.PubMedGoogle Scholar
  12. 12.
    Bromberg BI, Beekman RH, Rocchini AP, Snider RA, Bank ER, Heidelberger K, Rosenthal A: Aortic aneurysm after patch aortoplasty repair of coarctation: a prospective analysis of prevalence, screening tests and risks. J Am Coll Cardiol 14:734,1989.PubMedCrossRefGoogle Scholar
  13. 13.
    Clagett OT, Kirklin JW, Edwards JE: Anatomic variations and pathologic changes in coarctation of the aorta: a study of 124 cases. Surg Gynecol Obstet 98:103,1954.PubMedGoogle Scholar
  14. 14.
    Clarkson PM, Brandt PWT, Barratt-Boyes BG, Rutherford JD, Kerr AR, Neutze JM: Prosthetic repair of coarctation of the aorta with particular reference to Dacron onlay patch grafts and late aneurysm formation. Am J Cardiol 56:342,1985.PubMedCrossRefGoogle Scholar
  15. 15.
    Cohen M, Fuster V, Steele PM, Driscoll D, McGoon DC: Coarctation of the aorta: long-term follow-up and prediction of outcome after surgical correction. Circulation 80:840,1989.PubMedCrossRefGoogle Scholar
  16. 16.
    Connors JP, Hartmann AF, Weldon CS: Considerations in the surgical management of infantile coarctation of the aorta. Am J Cardiol 36:489,1975.PubMedCrossRefGoogle Scholar
  17. 17.
    Cooley DA: Techniques in Cardiac Surgery, 2nd ed. Philadelphia, WB Saunders Co, 1984, p 49.Google Scholar
  18. 18.
    Cooper RS, Ritter SB, Rothe WB, Chen CK, Griepp R, Golinko RJ: Angioplasty for coarctation of the aorta: long-term results. Circulation 75:600,1987.PubMedCrossRefGoogle Scholar
  19. 19.
    Cooper SG, Sullivan ID, Wren C: Treatment of recoarctation: balloon dilation angioplasty. J Am Coll Cardiol 14:413,1989.PubMedCrossRefGoogle Scholar
  20. 20.
    Crafoord C, Nylin G: Congenital coarctation of the aorta and its surgical treatment. J Thorac Surg 14:347,1945.Google Scholar
  21. 21.
    Dietl CA, Torres AR: Coarctation of the aorta: anastomotic enlargement with subclavian artery: two new surgical options. Ann Thorac Surg 43:224,1987.PubMedCrossRefGoogle Scholar
  22. 22.
    Dietl CA, Torres AR, Favaloro RG, Fessier CL, Grunkemeier GL: Risk of recoarctation in neonates and infants after repair with patch aortoplasty, subclavian flap, and the combined resection-flap procedure. J Thorac Cardiovasc Surg 103: 724,1992.PubMedGoogle Scholar
  23. 23.
    Edie RN, Janani J, Attai LA, Malm JR, Robinson G: Bypass grafts for recurrent or complex coarctations of the aorta. Ann Thorac Surg 20:558,1975.PubMedCrossRefGoogle Scholar
  24. 24.
    Fenchel G, Steil E, Seybold-Epting W, Seboldt H, Apitz J, Hoffmeister H-E: Repair of symptomatic aortic coarctation in the first three months of life: early and late results after resection and end-to-end anastomosis and subclavian flap angioplasty. J Cardiovasc Surg 29:257,1988.Google Scholar
  25. 25.
    Gidding SS, Rocchini AP, Beekman R, Szpunar CA, Moorehead C, Behrendt D, Rosenthal A: Therapeutic effect of propranolol on paradoxical hypertension after repair of coarctation of the aorta. N Engl J Med 312:1224,1985.PubMedCrossRefGoogle Scholar
  26. 26.
    Goldman S, Hernandez J, Pappas G: Results of surgical treatment of coarctation of the aorta in the critically ill neonate: including the influence of pulmonary artery banding. J Thorac Cardiovasc Surg 91:732,1986.PubMedGoogle Scholar
  27. 27.
    Graham TP, Atwood GF, Boerth RC, Boucek RJ, Smith CW: Right and left heart size and function in infants with symptomatic coarctation. Circulation 56:641, 1977.PubMedGoogle Scholar
  28. 28.
    Herrmann VM, Laks H, Fagan L, Terschluse D, Willman VL: Repair of aortic coarctation in the first year of life. Ann Thorac Surg 25:57,1978.PubMedCrossRefGoogle Scholar
  29. 29.
    Ho ECK, Moss AJ: The syndrome of “mesenteric arteritis” following surgical repair of aortic coarctation. Pediatrics 49:40,1972.PubMedGoogle Scholar
  30. 30.
    Hughes RK, Reemtsma K: Correction of coarctation of the aorta: manometric determination of safety during test occlusion. J Thorac Cardiovasc Surg 62:31, 1971.PubMedGoogle Scholar
  31. 31.
    Hujazi ZM, Fahey JT, Kleinman CS, Hellenbrand WE: Balloon angioplasty for recurrent coarctation of the aorta: immediate and long-term results. Circulation 84:1150,1991.Google Scholar
  32. 32.
    Jacob T, Cobanoglu A, Starr A: Late results of ascending aorta-descending aorta bypass grafts for recurrent coarctation of the aorta. J Thorac Cardiovasc Surg 95: 78,1988.Google Scholar
  33. 33.
    James FW, Kaplan S: Systolic hypertension during submaximal exercise after correction of coarctation of aorta. Circulation 49,50(Suppl II): II–27,1974.Google Scholar
  34. 34.
    Johnson MC, Canter CE, Strauss AW, Spray TL: Repair of coarctation of the aorta in infancy: comparison of surgical and balloon angioplasty. Am Heart J 125: 464,1993.PubMedCrossRefGoogle Scholar
  35. 35.
    Keith JD, Rowe RD, Vlad P: Heart Disease in Infancy and Childhood, 2nd ed. New York, Macmillan, 1967, p 216.Google Scholar
  36. 36.
    Kron IL, Flanagan TL, Rheuban KS, Carpenter MA, Gutgesell HP, Blackbourne LH, Nolan SP: Incidence and risk of reintervention after coarctation repair. Ann Thorac Surg 49:920,1990.PubMedCrossRefGoogle Scholar
  37. 37.
    Lababidi ZA, Daskalopoulos DA, Stoeckle H: Transluminal balloon coarctation angioplasty: experience with 27 patients. Am J Cardiol 54:1288,1984.PubMedCrossRefGoogle Scholar
  38. 38.
    Lacour-Gayet F, Conte S, Serraf A, Bruniaux J, Sousa-Uva M, Planche C: Surgical management of neonatal coarctation: a study of 221 patients. Presented at the American Association for Thoracic Surgery, 1993.Google Scholar
  39. 39.
    Lansman S, Shapiro AJ, Schiller MS, Ritter S, Cooper R, Galla JD, Lowery RC, Golinko R, Ergin A, Griepp RB: Extended aortic arch anastomosis for repair of coarctation in infancy. Circulation 74(Suppl I): I–37,1986.Google Scholar
  40. 40.
    Leandro J, Smallhorn JF, Benson L, Musewe N, Balfe JW, Dyck JD, West L, Freedom R: Ambulatory blood pressure monitoring and left ventricular mass and function after successful surgical repair of coarctation of the aorta. J Am Coll Cardiol 20:197,1992.PubMedCrossRefGoogle Scholar
  41. 41.
    Lock JE, Bass JL, Amplatz K, Fuhrman BP, Castaneda-Zuniga W: Balloon dilatation angioplasty of aortic coarctations in infants and children. Circulation 68: 109,1983.PubMedCrossRefGoogle Scholar
  42. 42.
    Lock JE, Niemi T, Burke BA, Einzig S, Castaneda-Zuniga WR: Transcutaneous angioplasty of experimental aortic coarctation. Circulation 68:1280,1982.CrossRefGoogle Scholar
  43. 43.
    Macmanus Q, Starr A, Lambert LE, Grunkemeier GL: Correction of aortic coarctation in neonates: mortality and late results. Ann Thorac Surg 24:544,1977.PubMedCrossRefGoogle Scholar
  44. 44.
    Maron BJ, Humphries JO, Rowe RD, Mellits ED: Prognosis of surgically corrected coarctation of the aorta. Circulation 47:119,1973.PubMedGoogle Scholar
  45. 45.
    Mays ET, Sergeant CK: Postcoarctectomy syndrome. Arch Surg 91:58,1965.Google Scholar
  46. 46.
    Meier MA, Lucchese FA, Jazbik W, Nesralla IA, Mendonca JT: A new technique for repair of aortic coarctation: subclavian flap aortoplasty with preservation of arterial blood flow to the left arm. J Thorac Cardiovasc Surg 92:1005,1986.PubMedGoogle Scholar
  47. 47.
    Metzdorff MT, Cobanoglu A, Grunkemeier GL, Sunderland CO, Starr A: Influence of age at operation on late results with subclavian flap aortoplasty. J Thorac Cardiovasc Surg 89:235,1985.PubMedGoogle Scholar
  48. 48.
    Morrow WR, Huhta JC, Murphy DJ, McNamara DG: Quantitative morphology of the aortic arch in neonatal coarctation. J Am Coll Cardiol 8:616,1986.PubMedCrossRefGoogle Scholar
  49. 49.
    Moulaert AJ, Bruins CC, Oppenheimer-Decker A: Anomalies of the aortic arch and ventricular septal defects. Circulation 53:1011,1976.PubMedGoogle Scholar
  50. 50.
    Myers JL, Campbell DB, Waldhausen JA: The use of absorbable monofilament polydioxanone suture in pediatric cardiovascular operations. J Thorac Cardiovasc Surg 92:771,1986.PubMedGoogle Scholar
  51. 51.
    Myers JL, Waldhausen JA, Pae WE, Abt AB, Prophet GA, Pierce WS: Vascular anastomoses in growing vessels: the use of absorbable sutures. Ann Thorac Surg 34:529,1982.PubMedCrossRefGoogle Scholar
  52. 52.
    Palatianos GM, Thurer RJ, Kaiser GA: Comparison of operations for coarctation of the aorta in infants. J Cardiovasc Surg 28:128,1987.Google Scholar
  53. 53.
    Park JK, Dell RB, Ellis K, Gersony WM: Surgical management of the infant with coarctation of the aorta and ventricular septal defect. J Am Coll Cardiol 20: 176,1992.PubMedCrossRefGoogle Scholar
  54. 54.
    Rao PS: Balloon angioplasty for coarctation of the aorta in infancy. J Pediatr 110: 713,1987.PubMedCrossRefGoogle Scholar
  55. 55.
    Rao PS, Chopra PS: Role of balloon angioplasty in the treatment of aortic coarctation. Ann Thorac Surg 52:621,1991.PubMedCrossRefGoogle Scholar
  56. 56.
    Redington AN, Booth P, Shore DF, Rigby ML: Primary balloon dilatation of coarctation of the aorta in neonates. Br Heart J 64:277,1990.PubMedCrossRefGoogle Scholar
  57. 57.
    Reifenstein GH, Levine SA, Gross RE: Coarctation of the aorta: a review of 104 autopsied cases of the “adult type,” 2 years of age or older. Am Heart J 33: 146,1947.PubMedCrossRefGoogle Scholar
  58. 58.
    Rocchini AP, Rosenthal A, Barger AC, Castaneda AR, Nadas AS: Pathogenesis of paradoxical hypertension after coarctation resection. Circulation 54:382,1976.PubMedGoogle Scholar
  59. 59.
    Sanchez GR, Balsara RK, Dunn JM, Mehta AV, O’Riordan AC: Recurrent obstruction after subclavian flap repair of coarctation of the aorta in infants: can it be predicted or prevented? J Thorac Cardiovasc Surg 91:738,1986.PubMedGoogle Scholar
  60. 60.
    Sciolaro C, Copeland J, Cork R, Barkenbush M, Donnerstein R, Goldberg S: Long-term follow-up comparing subclavian flap angioplasty to resection with modified end-to-end anastomosis. J Thorac Cardiovasc Surg 101:1,1991.PubMedGoogle Scholar
  61. 61.
    Sealy WC: Coarctation of the aorta and hypertension. Ann Thorac Surg 3:15,1967.PubMedCrossRefGoogle Scholar
  62. 62.
    Sealy WC: Paradoxical hypertension after repair of coarctation of the aorta: a review of its causes. Ann Thorac Surg 50:323,1990.PubMedCrossRefGoogle Scholar
  63. 63.
    Shaddy RE, Boucek MM, Sturtevant JE, Ruttenberg HD, Jaffe RB, Tani LY, Judd VE, Veasy LG, McGough EC, Orsmond GS: Comparison of angioplasty and surgery for unoperated coarctation of the aorta. Circulation 87:793,1993.PubMedGoogle Scholar
  64. 64.
    Shenberger JS, Prophet SA, Waldhausen JA, Davidson WR, Sinoway LI: Left subclavian flap aortoplasty for coarctation of the aorta: effects on forearm vascular function and growth. J Am Coll Cardiol 14:953,1989.PubMedCrossRefGoogle Scholar
  65. 65.
    Sinha SN, Kardatzke ML, Cole RB, Muster AJ, Wessel JU, Paul MH: Coarctation of the aorta in infancy. Circulation 40:385,1969.PubMedGoogle Scholar
  66. 66.
    Smerling A, Gersony WM: Esmolol for severe hypertension following repair of aortic coarctation. Crit Care Med 18:1288,1990.PubMedCrossRefGoogle Scholar
  67. 67.
    Sos T, Sniderman KW, Rettek-Sos B, Strupp A, Alonso DR: Percutaneous transluminal dilatation of coarctation of thoracic aorta post mortem. Lancet 2:970,1979.PubMedCrossRefGoogle Scholar
  68. 68.
    Stansel HC, Tabry IF, Poirier RA, Berman MA, Hellenbrand WE: One hundred consecutive coarctation resections followed from one to thirteen years. J Pediat Surg 12:279,1977.PubMedCrossRefGoogle Scholar
  69. 69.
    Trinquet F, Vouhe PR, Vernant F, Touati G, Roux P-M, Pome G, Leca F, Neveux J-Y: Coarctation of the aorta in infants: which operation? Ann Thorac Surg 45: 186,1988.PubMedCrossRefGoogle Scholar
  70. 70.
    van Son JAM, Daniels O, Vincent JG, van Lier HJJ, Lacquet LK: Appraisal of resection and end-to-end anastomosis for repair of coarctation of the aorta in infancy: preference for resection. Ann Thorac Surg 48:496,1989.PubMedCrossRefGoogle Scholar
  71. 71.
    Vincent RN, Click LA, Williams HM, Plauth WH, Williams WH: Esmolol as an adjunct in the treatment of systemic hypertension after operative repair of coarctation of the aorta. Am J Cardiol 65:941,1990.PubMedCrossRefGoogle Scholar
  72. 72.
    Vouhe PR, Trinquet F, Lecompte Y, Vernant F, Roux P-M, Touati G, Pome G, Leca F, Neveux J-Y: Aortic coarctation with hypoplastic aortic arch: results of extended end-to-end aortic arch anastomosis. J Thorac Cardiovasc Surg 96: 557,1988.PubMedGoogle Scholar
  73. 73.
    Waldhausen JA, Nahrwold DL: Repair of coarctation of the aorta with a subclavian flap. J Thorac Cardiovasc Surg 51:532,1966.PubMedGoogle Scholar
  74. 74.
    Waldman JD: Make balloon dilatation an approved procedure for recurrent coarctation in children (editorial). Circulation 84:1440,1991.PubMedGoogle Scholar
  75. 75.
    Waldman JD, Karp RB: How should we treat coarctation of the aorta? (editorial). Circulation 87:1043,1993.PubMedGoogle Scholar
  76. 76.
    Watterson KG, Dhasmana JP, O’Higgins JW, Wisheart JD: Distal aortic pressure during coarctation operation. Ann Thorac Surg 49:987,1990.PubMedCrossRefGoogle Scholar
  77. 77.
    Weldon CS, Hartmann AF, Steinhoff NG, Morrissey JD: A simple, safe and rapid technique for the management of recurrent coarctation of the aorta. Ann Thorac Surg 15:510,1973.PubMedCrossRefGoogle Scholar
  78. 78.
    Will RJ, Walker OM, Traugott RC, Treasure RL: Sodium nitroprusside and propranolol therapy for management of postcoarctectomy hypertension. J Thorac Cardiovasc Surg 75:722,1978.PubMedGoogle Scholar
  79. 79.
    Ziemer G, Jonas RA, Perry SB, Freed MD, Castaneda AR: Surgery for coarctation of the aorta in the neonate. Circulation 74(Suppl I):I–25,1986.Google Scholar

Copyright information

© Springer-Verlag New York, Inc. 1995

Authors and Affiliations

  • Bradley J. Harlan
    • 1
    • 2
    • 3
  • Albert Starr
    • 3
    • 4
    • 5
  • Fredic M. Harwin
    • 6
  • Alain Carpentier
    • 7
  1. 1.Section of Thoracic and Cardiovascular SurgerySutter Memorial HospitalSacramentoUSA
  2. 2.Davis Medical SchoolUniversity of CaliforniaSacramentoUSA
  3. 3.Oregon Health Sciences UniversityPortlandUSA
  4. 4.Heart Institute at St. Vincent HospitalPortlandUSA
  5. 5.Starr-Wood Cardiac Group, P.C.PortlandUSA
  6. 6.Harwin StudiosPortlandUSA
  7. 7.Hôpital BroussaisUniversity of ParisParisFrance

Personalised recommendations