Skip to main content

Aortic Coarctation Repairs

  • Chapter
  • First Online:
  • 2810 Accesses

Abstract

The first surgical repair of aortic coarctation was performed in 1944 [1]. Since then three basic surgical methods have evolved for repair of classic short-segment aortic coarctation (CoAo): resection of the coarcted segment with end-to-end anastomosis (Fig. 32.1), subclavian flap aortoplasty (distal left subclavian artery used to augment aortic lumen at the coarctation site), and prosthetic patch aortoplasty (prosthetic patch inserted to widen the aortic lumen) [2]. The choice of procedure depends on the age of the patient, the type of associated malformations, and the morphology of the coarctation itself. Surgical treatment is preferred in neonates and infants. The other procedure types have been used in adults. Subclavian flap aortoplasty is no longer commonly performed because it requires sacrifice of the left subclavian artery which leads to arm claudication with exercise and diminished growth of the left arm [3].

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

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover 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

Learn about institutional subscriptions

References

  1. Shih MC, Tholpady A, Kramer CM, et al. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. Am J Roentgenol. 2006;187(3):w302–12.

    Article  Google Scholar 

  2. Gibbs JL. Treatment options for coarctation of the aorta. Heart. 2000;84:11–3.

    Article  PubMed  CAS  Google Scholar 

  3. Diemont FF, Chemla ES, Julia PL, Sirieix D, Fabiani JN. Upper limb ischemia after subclavian flap aortoplasty: unusual long-term complication. Ann Thorac Surg. 2000;69:1576–8.

    Article  PubMed  CAS  Google Scholar 

  4. Hijazi ZM, Fahey JT, Kleinman CS, Hellenbrand WE. Balloon angioplasty for recurrent coarctation of aorta. Immediate and long-term results. Circulation. 1991;84:1150–6.

    Article  PubMed  CAS  Google Scholar 

  5. Fletcher SE, Nihill MR, Grifka RG, O’Laughlin MP, Mullins CE. Balloon angioplasty of native coarctation of the aorta: midterm follow-up and prognostic factors. J Am Coll Cardiol. 1995;25:730–4. doi:10.1016/0735-1097(94)00437-U.

    Article  PubMed  CAS  Google Scholar 

  6. Mendelsohn AM, Lloyd TR, Crowley DC, Sandhu SK, Kocis KC, Beekman 3rd RH. Late follow-up of balloon angioplasty in children with a native coarctation of the aorta. Am J Cardiol. 1994;74:696–700.

    Article  PubMed  CAS  Google Scholar 

  7. Thanopoulos BD, Hadjinikolaou L, Konstadopoulou GN, Tsaousis GS, Triposkiadis F, Spirou P. Stent treatment for coarctation of the aorta: intermediate term follow up and technical considerations. Heart. 2000;84:65–70.

    Article  PubMed  CAS  Google Scholar 

  8. 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. 1989;80:840–5.

    Article  PubMed  CAS  Google Scholar 

  9. Presbitero P, Demarie D, Villani M, Perinetto EA, Riva G, Orzan F, et al. Long term results (15–30 years) of surgical repair of aortic coarctation. Br Heart J. 1987;57:462–7.

    Article  PubMed  CAS  Google Scholar 

  10. Seirafi PA, Warner KG, Geggel RL, Payne DD, Cleveland RJ. Repair of coarctation of the aorta during infancy minimizes the risk of late hypertension. Ann Thorac Surg. 1998;66:1378–82.

    Article  PubMed  CAS  Google Scholar 

  11. Walhout RJ, Lekkerkerker JC, Oron GH, Hitchcock FJ, Meijboom EJ, Bennink GB. Comparison of polytetrafluoroethylene patch aortoplasty and end-to-end anastomosis for coarctation of the aorta. J Thorac Cardiovasc Surg. 2003;126:521–8.

    Article  PubMed  Google Scholar 

  12. Backer CL, Paape K, Zales VR, Weigel TJ, Mavroudis C. Coarctation of the aorta. Repair with polytetrafluoroethylene patch aortoplasty. Circulation. 1995;92:II132–6.

    Article  PubMed  CAS  Google Scholar 

  13. Lundqvist B, Almgren B, Bowald S, Lorelius LE, Eriksson I. Deterioration and dilatation of Dacron prosthetic grafts. Acta Chir Scand Suppl. 1985;529:81–5.

    PubMed  CAS  Google Scholar 

  14. Heikkinen LO, Ala-Kulju KV, Salo JA. Dilatation of ascending aorta in patients with repaired coarctation. Scand J Thorac Cardiovasc Surg. 1991;25:25–8.

    Article  PubMed  CAS  Google Scholar 

  15. Maron BJ, Humphries JO, Rowe RD, Mellits ED. Prognosis of ­surgically corrected coarctation of the aorta. A 20-year postoperative appraisal. Circulation. 1973;47:119–26.

    Article  PubMed  CAS  Google Scholar 

  16. Mahadevan V, Mullen MJ. Endovascular management of aortic coarctation. Int J Cardiol. 2004;97 Suppl 1:75–8. doi:10.1016/j.ijcard.2004.08.011.

    Article  PubMed  Google Scholar 

  17. de Suarez Lezo J, Pan M, Romero M, Segura J, Pavlovic D, Ojeda S, et al. Percutaneous interventions on severe coarctation of the aorta: a 21-year experience. Pediatr Cardiol. 2005;26:176–89. doi:10.1007/s00246-004-0961-5.

    Article  Google Scholar 

  18. de Suarez Lezo J, Pan M, Romero M, Medina A, Segura J, Lafuente M, et al. Immediate and follow-up findings after stent treatment for severe coarctation of aorta. Am J Cardiol. 1999;83:400–6.

    Article  Google Scholar 

  19. Harrison DA, McLaughlin PR, Lazzam C, Connelly M, Benson LN. Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: one year follow up. Heart. 2001;85:561–6.

    Article  PubMed  CAS  Google Scholar 

  20. Hughes Jr D, Siegel MJ. Computed tomography of adult congenital heart disease. Radiol Clin North Am. 2010;48:817–35. doi:10.1016/j.rcl.2010.04.005.

    Article  PubMed  Google Scholar 

  21. Shih MC, Tholpady A, Kramer CM, Sydnor MK, Hagspiel KD. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. AJR Am J Roentgenol. 2006;187:W302–12. doi:10.2214/AJR.05.0424.

    Article  PubMed  Google Scholar 

  22. Siegel MJ. CT evaluation of congenital heart disease in adults. Appl Radiol. 2005;34:61–8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Mazur, W., Siegel, M.J., Miszalski-Jamka, T., Pelberg, R. (2013). Aortic Coarctation Repairs. In: CT Atlas of Adult Congenital Heart Disease. Springer, London. https://doi.org/10.1007/978-1-4471-5088-6_32

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5088-6_32

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5087-9

  • Online ISBN: 978-1-4471-5088-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics