Isolated Coarctation of the Aorta: Current Concepts and Perspectives

Frontiers in Cardiovascular Medicine

article

Ami B. Bhatt¹  Maria R. Lantin-Hermoso²  Curt J. Daniels³  Robert Jaquiss⁴  Benjamin John Landis⁵  Bradley S. Marino⁶  Rahul H. Rathod⁷  Robert N. Vincent⁸  Bradley B. Keller⁹  Juan Villafane⁹ 

[1] Departments of Internal Medicine and Pediatrics and Division of Cardiology, Harvard Medical School;Section of Cardiology, Department of Pediatrics, Baylor College of Medicine;Departments of Pediatrics and Internal Medicine, The Ohio State University Medical Center;Department of Cardiovascular and Thoracic Surgery and Department of Pediatrics, UT Southwestern Medical Center;Department of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine;Department of Pediatric Cardiology, Cleveland Clinic Children's;Department of Pediatrics, Harvard Medical School;Department of Pediatrics, New York Medical College;Cincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati

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

DOI  :  10.3389/fcvm.2022.817866

学科分类：地球科学(综合)

来源: Frontiers

【 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】

CC BY