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Coarctation of Aorta
Santiago Martínez-Jiménez, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Coarctation of aorta (CoA, coarc)
              • Definitions

                • Congenital narrowing of aorta, most commonly occurring just distal to left subclavian artery origin
                • Atypical coarctation: Not involving isthmus (usually abdominal aorta)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Echocardiographic Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Bhave NM et al: Multimodality imaging of thoracic aortic diseases in adults. JACC Cardiovasc Imaging. 11(6):902-19, 2018
                                                  2. Dijkema EJ et al: Diagnosis, imaging and clinical management of aortic coarctation. Heart. 103(15):1148-55, 2017
                                                  3. Gach P et al: Multimodality imaging of aortic coarctation: from the fetus to the adolescent. Diagn Interv Imaging. 97(5):581-90, 2016
                                                  4. Karaosmanoglu AD et al: CT and MRI of aortic coarctation: pre- and postsurgical findings. AJR Am J Roentgenol. 204(3):W224-33, 2015
                                                  5. Muzzarelli S et al: Usefulness of cardiovascular magnetic resonance imaging to predict the need for intervention in patients with coarctation of the aorta. Am J Cardiol. 109(6):861-5, 2012
                                                  6. Kim HK et al: Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population. AJR Am J Roentgenol. 196(2):454-60, 2011
                                                  7. Muzzarelli S et al: Prediction of hemodynamic severity of coarctation by magnetic resonance imaging. Am J Cardiol. 108(9):1335-40, 2011
                                                  8. Teo LL et al: Prevalence of associated cardiovascular abnormalities in 500 patients with aortic coarctation referred for cardiovascular magnetic resonance imaging to a tertiary center. Pediatr Cardiol. 32(8):1120-7, 2011
                                                  9. Hope MD et al: Clinical evaluation of aortic coarctation with 4D flow MR imaging. J Magn Reson Imaging. 31(3):711-8, 2010
                                                  10. Kimura-Hayama ET et al: Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 30(1):79-98, 2010
                                                  11. Gaca AM et al: Repair of congenital heart disease: a primer--Part 2. Radiology. 248(1):44-60, 2008
                                                  12. Hom JJ et al: Velocity-encoded cine MR imaging in aortic coarctation: functional assessment of hemodynamic events. Radiographics. 28(2):407-16, 2008
                                                  13. Warnes CA et al: ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 118(23):e714-833, 2008
                                                  14. Ou P et al: Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg. 132(5):1105-11, 2006
                                                  15. Shih MC et al: Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. AJR Am J Roentgenol. 187(3):W302-12, 2006
                                                  16. de Bono JP et al: Long term follow up of patients with repaired aortic coarctations. Heart. 91(4):537-8, 2005
                                                  17. Konen E et al: Coarctation of the aorta before and after correction: the role of cardiovascular MRI. AJR Am J Roentgenol. 182(5):1333-9, 2004
                                                  18. Lee EY et al: MDCT evaluation of thoracic aortic anomalies in pediatric patients and young adults: comparison of axial, multiplanar, and 3D images. AJR Am J Roentgenol. 182(3):777-84, 2004
                                                  19. Sebastià C et al: Aortic stenosis: spectrum of diseases depicted at multisection CT. Radiographics. 23 Spec No:S79-91, 2003
                                                  20. Steffens JC et al: Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging. Circulation. 90(2):937-43, 1994
                                                  21. Sloan RD et al: Coarctation of the aorta; the roentgenologic aspects of one hundred and twenty-five surgically confirmed cases. Radiology. 61(5):701-21, 1953
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Abbreviations

                                                                • Coarctation of aorta (CoA, coarc)
                                                              • Definitions

                                                                • Congenital narrowing of aorta, most commonly occurring just distal to left subclavian artery origin
                                                                • Atypical coarctation: Not involving isthmus (usually abdominal aorta)

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Echocardiographic Findings

                                                                        • Angiographic Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Bhave NM et al: Multimodality imaging of thoracic aortic diseases in adults. JACC Cardiovasc Imaging. 11(6):902-19, 2018
                                                                                                  2. Dijkema EJ et al: Diagnosis, imaging and clinical management of aortic coarctation. Heart. 103(15):1148-55, 2017
                                                                                                  3. Gach P et al: Multimodality imaging of aortic coarctation: from the fetus to the adolescent. Diagn Interv Imaging. 97(5):581-90, 2016
                                                                                                  4. Karaosmanoglu AD et al: CT and MRI of aortic coarctation: pre- and postsurgical findings. AJR Am J Roentgenol. 204(3):W224-33, 2015
                                                                                                  5. Muzzarelli S et al: Usefulness of cardiovascular magnetic resonance imaging to predict the need for intervention in patients with coarctation of the aorta. Am J Cardiol. 109(6):861-5, 2012
                                                                                                  6. Kim HK et al: Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population. AJR Am J Roentgenol. 196(2):454-60, 2011
                                                                                                  7. Muzzarelli S et al: Prediction of hemodynamic severity of coarctation by magnetic resonance imaging. Am J Cardiol. 108(9):1335-40, 2011
                                                                                                  8. Teo LL et al: Prevalence of associated cardiovascular abnormalities in 500 patients with aortic coarctation referred for cardiovascular magnetic resonance imaging to a tertiary center. Pediatr Cardiol. 32(8):1120-7, 2011
                                                                                                  9. Hope MD et al: Clinical evaluation of aortic coarctation with 4D flow MR imaging. J Magn Reson Imaging. 31(3):711-8, 2010
                                                                                                  10. Kimura-Hayama ET et al: Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 30(1):79-98, 2010
                                                                                                  11. Gaca AM et al: Repair of congenital heart disease: a primer--Part 2. Radiology. 248(1):44-60, 2008
                                                                                                  12. Hom JJ et al: Velocity-encoded cine MR imaging in aortic coarctation: functional assessment of hemodynamic events. Radiographics. 28(2):407-16, 2008
                                                                                                  13. Warnes CA et al: ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 118(23):e714-833, 2008
                                                                                                  14. Ou P et al: Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg. 132(5):1105-11, 2006
                                                                                                  15. Shih MC et al: Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. AJR Am J Roentgenol. 187(3):W302-12, 2006
                                                                                                  16. de Bono JP et al: Long term follow up of patients with repaired aortic coarctations. Heart. 91(4):537-8, 2005
                                                                                                  17. Konen E et al: Coarctation of the aorta before and after correction: the role of cardiovascular MRI. AJR Am J Roentgenol. 182(5):1333-9, 2004
                                                                                                  18. Lee EY et al: MDCT evaluation of thoracic aortic anomalies in pediatric patients and young adults: comparison of axial, multiplanar, and 3D images. AJR Am J Roentgenol. 182(3):777-84, 2004
                                                                                                  19. Sebastià C et al: Aortic stenosis: spectrum of diseases depicted at multisection CT. Radiographics. 23 Spec No:S79-91, 2003
                                                                                                  20. Steffens JC et al: Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging. Circulation. 90(2):937-43, 1994
                                                                                                  21. Sloan RD et al: Coarctation of the aorta; the roentgenologic aspects of one hundred and twenty-five surgically confirmed cases. Radiology. 61(5):701-21, 1953