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Aortic Coarctation
Randy R. Richardson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Narrowing of aortic lumen with obstruction to blood flow
            • Category of congenital heart disease: Acyanotic, normal heart size (most commonly), normal pulmonary vascularity
            • Hemodynamics: Left ventricular (LV) pressure overload

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Echocardiographic Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Arar Y et al: 3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions. Cardiol Young. 30(5):656-62, 2020
                                              2. Cassar MP et al: Ascending aortic dissection in a pregnant patient with neonatally repaired coarctation of aorta and bicuspid aortic valve. BMJ Case Rep. 12(12), 2019
                                              3. Kleszcz J et al: Assessing a new coarctation repair simulator based on real patient's anatomy. Cardiol Young. 29(12):1517-21, 2019
                                              4. Kang SL et al: Stent therapy for aortic coarctation in children <30 kg: use of the low profile valeo stent. Pediatr Cardiol. 38(7):1441-9, 2017
                                              5. Rose-Felker K et al: Preoperative use of CT angiography in infants with coarctation of the aorta. World J Pediatr Congenit Heart Surg. 8(2):196-202, 2017
                                              6. Thakkar AN et al: Imaging adult patients with coarctation of the aorta. Curr Opin Cardiol. 32(5):503-12, 2017
                                              7. Casas B et al: 4D flow MRI-based pressure loss estimation in stenotic flows: evaluation using numerical simulations. Magn Reson Med. 75(4):1808-21, 2016
                                              8. Chen CK et al: Left ventricular myocardial and hemodynamic response to exercise in young patients after endovascular stenting for aortic coarctation. J Am Soc Echocardiogr. 29(3):237-46, 2016
                                              9. Nance JW et al: Coarctation of the aorta in adolescents and adults: a review of clinical features and CT imaging. J Cardiovasc Comput Tomogr. 10(1):1-12, 2016
                                              10. Urbina J et al: Realistic aortic phantom to study hemodynamics using MRI and cardiac catheterization in normal and aortic coarctation conditions. J Magn Reson Imaging. 44(3):683-97, 2016
                                              11. Karaosmanoglu AD et al: CT and MRI of aortic coarctation: pre- and postsurgical findings. AJR Am J Roentgenol. 204(3):W224-33, 2015
                                              12. Rengier F et al: Noninvasive 4D pressure difference mapping derived from 4D flow MRI in patients with repaired aortic coarctation: comparison with young healthy volunteers. Int J Cardiovasc Imaging. 31(4):823-30, 2015
                                              13. Shepherd B et al: MRI in adult patients with aortic coarctation: diagnosis and follow-up. Clin Radiol. 70(4):433-45, 2015
                                              14. Valverde I et al: 3D printed models for planning endovascular stenting in transverse aortic arch hypoplasia. Catheter Cardiovasc Interv. 85(6):1006-12, 2015
                                              15. Riesenkampff E et al: Pressure fields by flow-sensitive, 4D, velocity-encoded CMR in patients with aortic coarctation. JACC Cardiovasc Imaging. 7(9):920-6, 2014
                                              16. Meyer S et al: A 13-year-old girl with arterial hypertension - mid-aortic syndrome. Klin Padiatr. 223(1):38-9, 2011
                                              17. Mohammadi A et al: Bilateral tardus-parvus waveforms in a patient with aortic coarctation. J Ultrasound Med. 30(7):1030-1, 2011
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Narrowing of aortic lumen with obstruction to blood flow
                                                        • Category of congenital heart disease: Acyanotic, normal heart size (most commonly), normal pulmonary vascularity
                                                        • Hemodynamics: Left ventricular (LV) pressure overload

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • Fluoroscopic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Echocardiographic Findings

                                                                    • Angiographic Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Arar Y et al: 3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions. Cardiol Young. 30(5):656-62, 2020
                                                                                          2. Cassar MP et al: Ascending aortic dissection in a pregnant patient with neonatally repaired coarctation of aorta and bicuspid aortic valve. BMJ Case Rep. 12(12), 2019
                                                                                          3. Kleszcz J et al: Assessing a new coarctation repair simulator based on real patient's anatomy. Cardiol Young. 29(12):1517-21, 2019
                                                                                          4. Kang SL et al: Stent therapy for aortic coarctation in children <30 kg: use of the low profile valeo stent. Pediatr Cardiol. 38(7):1441-9, 2017
                                                                                          5. Rose-Felker K et al: Preoperative use of CT angiography in infants with coarctation of the aorta. World J Pediatr Congenit Heart Surg. 8(2):196-202, 2017
                                                                                          6. Thakkar AN et al: Imaging adult patients with coarctation of the aorta. Curr Opin Cardiol. 32(5):503-12, 2017
                                                                                          7. Casas B et al: 4D flow MRI-based pressure loss estimation in stenotic flows: evaluation using numerical simulations. Magn Reson Med. 75(4):1808-21, 2016
                                                                                          8. Chen CK et al: Left ventricular myocardial and hemodynamic response to exercise in young patients after endovascular stenting for aortic coarctation. J Am Soc Echocardiogr. 29(3):237-46, 2016
                                                                                          9. Nance JW et al: Coarctation of the aorta in adolescents and adults: a review of clinical features and CT imaging. J Cardiovasc Comput Tomogr. 10(1):1-12, 2016
                                                                                          10. Urbina J et al: Realistic aortic phantom to study hemodynamics using MRI and cardiac catheterization in normal and aortic coarctation conditions. J Magn Reson Imaging. 44(3):683-97, 2016
                                                                                          11. Karaosmanoglu AD et al: CT and MRI of aortic coarctation: pre- and postsurgical findings. AJR Am J Roentgenol. 204(3):W224-33, 2015
                                                                                          12. Rengier F et al: Noninvasive 4D pressure difference mapping derived from 4D flow MRI in patients with repaired aortic coarctation: comparison with young healthy volunteers. Int J Cardiovasc Imaging. 31(4):823-30, 2015
                                                                                          13. Shepherd B et al: MRI in adult patients with aortic coarctation: diagnosis and follow-up. Clin Radiol. 70(4):433-45, 2015
                                                                                          14. Valverde I et al: 3D printed models for planning endovascular stenting in transverse aortic arch hypoplasia. Catheter Cardiovasc Interv. 85(6):1006-12, 2015
                                                                                          15. Riesenkampff E et al: Pressure fields by flow-sensitive, 4D, velocity-encoded CMR in patients with aortic coarctation. JACC Cardiovasc Imaging. 7(9):920-6, 2014
                                                                                          16. Meyer S et al: A 13-year-old girl with arterial hypertension - mid-aortic syndrome. Klin Padiatr. 223(1):38-9, 2011
                                                                                          17. Mohammadi A et al: Bilateral tardus-parvus waveforms in a patient with aortic coarctation. J Ultrasound Med. 30(7):1030-1, 2011