Isolated Coarctation of the Aorta: Current Concepts and Perspectives

Frontiers in Cardiovascular Medicine

Juan Villafane¹  Bradley B. Keller¹  Robert Jaquiss²  Bradley S. Marino³  Benjamin John Landis⁴  Rahul H. Rathod⁵  Robert N. Vincent⁶  Ami B. Bhatt⁷  Curt J. Daniels⁸  Maria R. Lantin-Hermoso⁹ 

[1] Cincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States;Department of Cardiovascular and Thoracic Surgery and Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States;Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, OH, United States;Department of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, United States;Department of Pediatrics, Harvard Medical School, Boston, MA, United States;Department of Pediatrics, New York Medical College, Valhalla, NY, United States;Departments of Internal Medicine and Pediatrics and Division of Cardiology, Harvard Medical School, Boston, MA, United States;Departments of Pediatrics and Internal Medicine, The Ohio State University Medical Center, Columbus, OH, United States;Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States;

关键词: coarctation of the aorta;    congenital heart disease;    catheter intervention;    heart surgery;    adult congenital heart disease;   

DOI  :  10.3389/fcvm.2022.817866

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown