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Critical Care Management of the Adult with Aortic Coarctation

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Intensive Care of the Adult with Congenital Heart Disease

Part of the book series: Congenital Heart Disease in Adolescents and Adults ((CHDAA))

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Abstract

Coarctation of the aorta while usually first recognized and treated in infancy and childhood is one of the more common congenital lesions that may be recognized for the first time in adulthood. For those treated as children, recurrent coarctation of the aorta may be encountered in the adult age group along with other complications of repair including aortic aneurysm. Unrepaired coarctation of the aorta or repaired coarctation with residual stenosis leads to premature atherosclerotic disease of the carotid and coronary arteries and early left ventricular systolic and diastolic dysfunction. Because of these issues, significant coarctation or recoarctation of the aorta presenting in adulthood is treated with surgery or with transcatheter stenting. Aortic aneurysms are usually addressed with transcatheter covered stents. Patients who undergo intervention for coarctation of the aorta are managed in an intensive care unit periprocedurally. Because of the relatively uncommon nature of this disease in the adult population, few ICUs have extensive experience in managing the adult with coarctation of the aorta. A multidisciplinary approach with congenital cardiologists, congenital cardiac surgeons, anesthesiologists, and intensive care physicians usually provides the best care.

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Author information

Authors and Affiliations

  1. Pediatrics and Medicine, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, USA

    Barry A. Love

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  1. Barry A. Love
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Correspondence to Barry A. Love .

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Editors and Affiliations

  1. Children’s Hospital Colorado, University of Colorado Denver, Aurora, CO, USA

    Eduardo da Cruz

  2. Pediatric Intensive Care, Royal Brompton & Harefield NHS Foundation Trust, London, UK

    Duncan Macrae

  3. Adult Congenital Heart Program, Heart Institute, Cincinnati Children Hospital Medical Center, Cincinnati, OH, USA

    Gary Webb

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Love, B.A. (2019). Critical Care Management of the Adult with Aortic Coarctation. In: da Cruz, E., Macrae, D., Webb, G. (eds) Intensive Care of the Adult with Congenital Heart Disease. Congenital Heart Disease in Adolescents and Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-94171-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-94171-4_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94170-7

  • Online ISBN: 978-3-319-94171-4

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