aortic coarctation


Summary: A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.

Top Publications

  1. Zwiers W, Blodgett T, Vallejo M, Finegold H. Successful vaginal delivery for a parturient with complete aortic coarctation. J Clin Anesth. 2006;18:300-3 pubmed
    ..Management of patients with complex cardiac anomalies requires consultation among cardiologist, obstetricians, and anesthesiologists to ensure good outcome for the mother and baby. ..
  2. Gillett C, Wong A, Wilson D, Wolf A, Martin R, Kenny D. Underrecognition of elevated blood pressure readings in children after early repair of coarctation of the aorta. Pediatr Cardiol. 2011;32:202-5 pubmed publisher
    ..When elevated BP is documented, in all cases no recorded action was taken. This may have significant implications for cardiovascular outcomes in this cohort of patients. ..
  3. Brown M, Burkhart H, Connolly H, Dearani J, Hagler D, Schaff H. Late outcomes of reintervention on the descending aorta after repair of aortic coarctation. Circulation. 2010;122:S81-4 pubmed publisher
    After repair of aortic coarctation, patients may develop restenosis, aneurysms, and pseudoaneurysms at the site of prior repair. We assessed the outcomes of late reintervention on the descending aorta after aortic coarctation repair...
  4. Holzer R, Qureshi S, Ghasemi A, Vincent J, Sievert H, Gruenstein D, et al. Stenting of aortic coarctation: acute, intermediate, and long-term results of a prospective multi-institutional registry--Congenital Cardiovascular Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv. 2010;76:553-63 pubmed publisher
  5. Forbes T, Kim D, Du W, Turner D, Holzer R, Amin Z, et al. Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium). J Am Coll Cardiol. 2011;58:2664-74 pubmed publisher
    ..Because of the nonrandomized nature of this study, these results should be interpreted with caution. ..
  6. Prada F, Mortera C, Bartrons J, Rissech M, Jimenez L, Carretero J, et al. Complex aortic coarctation and PHACE syndrome. Rev Esp Cardiol. 2010;63:1367-70 pubmed
    ..We report our findings in four patients with this syndrome, in whom it was characterized by complex aortic coarctation that required not only preoperative echocardiographic investigation, but also the use of techniques such as ..
  7. Bhat A, Davenport J, Cocalis M. Partial anomalous left pulmonary artery along with aortic coarctation in an infant with Kabuki syndrome. Echocardiography. 2012;29:E145-7 pubmed publisher
    ..While coarctation and hypoplastic left heart syndrome are observed in this syndrome, this is the second reported case of aLPA in KS and the first with the forme fruste of left-sided obstruction as well as aLPA in this group of patients...
  8. Luijendijk P, Bouma B, Vriend J, Vliegen H, Groenink M, Mulder B. Usefulness of exercise-induced hypertension as predictor of chronic hypertension in adults after operative therapy for aortic isthmic coarctation in childhood. Am J Cardiol. 2011;108:435-9 pubmed publisher
  9. Buys R, Van de Bruaene A, Muller J, Hager A, Khambadkone S, Giardini A, et al. Usefulness of cardiopulmonary exercise testing to predict the development of arterial hypertension in adult patients with repaired isolated coarctation of the aorta. Int J Cardiol. 2013;168:2037-41 pubmed publisher
    Patients who underwent surgery for aortic coarctation (COA) have an increased risk of arterial hypertension...

More Information


  1. Kumar T, Zurakowski D, Sharma R, Saini S, Jonas R. Prediction of recurrent coarctation by early postoperative blood pressure gradient. J Thorac Cardiovasc Surg. 2011;142:1130-6, 1136.e1 pubmed publisher
    ..Rapid growth of both the ascending and the transverse aorta is frequently observed and associated with improvement in gradients over time. ..
  2. LaDisa J, Dholakia R, Figueroa C, Vignon Clementel I, Chan F, Samyn M, et al. Computational simulations demonstrate altered wall shear stress in aortic coarctation patients treated by resection with end-to-end anastomosis. Congenit Heart Dis. 2011;6:432-43 pubmed publisher
    ..These regions can be visualized in familiar and intuitive ways allowing clinicians to track their contribution to morbidity in longitudinal studies. ..
  3. Keshavarz Motamed Z, Garcia J, Pibarot P, Larose E, Kadem L. Modeling the impact of concomitant aortic stenosis and coarctation of the aorta on left ventricular workload. J Biomech. 2011;44:2817-25 pubmed publisher
    ..This model can be used to optimize the management of patients with COA and AS in terms of the sequence of lesion repair. ..
  4. Siegel D, Tefft K, Kelly T, Johnson C, Metry D, Burrows P, et al. Stroke in children with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome: a systematic review of the literature. Stroke. 2012;43:1672-4 pubmed publisher
    ..The objective of this article is to review all cases of stroke in PHACE in children and describe clinical characteristics that may be associated with an increased risk of AIS...
  5. Porras D, Brown D, Marshall A, del Nido P, Bacha E, McElhinney D. Factors associated with subsequent arch reintervention after initial balloon aortoplasty in patients with Norwood procedure and arch obstruction. J Am Coll Cardiol. 2011;58:868-76 pubmed publisher
    ..The risk for arch reintervention is highest in patients with proximal arch obstruction, those age <3 months at the time of BD, and those with less successful acute results. ..
  6. LaDisa J, Alberto Figueroa C, Vignon Clementel I, Kim H, Xiao N, Ellwein L, et al. Computational simulations for aortic coarctation: representative results from a sampling of patients. J Biomech Eng. 2011;133:091008 pubmed publisher
    ..These results apply CFD to a range of CoA patients for the first time and provide the foundation for future progress in this area. ..
  7. Helbok R, Beer R, Chemelli A, Sohm F, Broessner G, Lackner P, et al. Multimodal neuromonitoring in a patient with aneurysmal subarachnoid hemorrhage associated with aortic coarctation. Neurocrit Care. 2011;14:433-7 pubmed publisher
    b>Aortic coarctation (AC) rarely remains undiagnosed until adulthood. Intracranial aneurysms and spontaneous subarachnoid hemorrhage (SAH) are more frequent in patients with AC than in the general population...
  8. Tagariello A, Breuer C, Birkner Y, Schmidt S, Koch A, Cesnjevar R, et al. Functional null mutations in the gonosomal homologue gene TBL1Y are associated with non-syndromic coarctation of the aorta. Curr Mol Med. 2012;12:199-205 pubmed
    ..Several studies have shown that Notch signalling is important for proper development of the left ventricular outflow tract. Our findings suggest that TBL1Y is involved in the genesis of non-syndromic coarctation of the aorta. ..
  9. Keshavarz Motamed Z, Garcia J, Maftoon N, Bedard E, Chetaille P, Kadem L. A new approach for the evaluation of the severity of coarctation of the aorta using Doppler velocity index and effective orifice area: in vitro validation and clinical implications. J Biomech. 2012;45:1239-45 pubmed publisher
    ..As a conclusion, COA Doppler velocity index and COA effective orifice area are flow independent and do not depend on aortic valve conditions. They can, then, more accurately predict the severity of COA. ..
  10. Idir M, Denisi R, Parrens M, Roudaut R, Deville C. Endarteritis and false aneurysm complicating aortic coarctation. Ann Thorac Surg. 2000;70:966-8; discussion 968-9 pubmed
    We report a tricky case of endocarditis because of the localization, aortic coarctation, and the pathogenic bacteria Actinobacillus actinomycetemcomitans...
  11. Hager A, Bildau J, Kreuder J, Kaemmerer H, Hess J. Impact of genomic polymorphism on arterial hypertension after aortic coarctation repair. Int J Cardiol. 2011;151:63-8 pubmed publisher
    Even after repair of aortic coarctation without restenosis there is a high incidence of arterial hypertension...
  12. English K. Stenting the mildly obstructive aortic arch: useful treatment or oculo-inflatory reflex?. Heart. 2006;92:1541-3 pubmed
  13. Kanter K, Vincent R, Fyfe D. Reverse subclavian flap repair of hypoplastic transverse aorta in infancy. Ann Thorac Surg. 2001;71:1530-6 pubmed
    ..Reverse subclavian flap aortoplasty is excellent for relief of arch hypoplasia and coarctation in infants with low recurrence rates and acceptable operative and intermediate survival. ..
  14. Ewert P, Peters B, Nagdyman N, Miera O, Kühne T, Berger F. Early and mid-term results with the Growth Stent--a possible concept for transcatheter treatment of aortic coarctation from infancy to adulthood by stent implantation?. Catheter Cardiovasc Interv. 2008;71:120-6 pubmed
    ..Growth Stent-a stent consisting of two stent halves connected by reabsorbable sutures-for the treatment of aortic coarctation in infants...
  15. Ou P, Celermajer D, Jolivet O, Buyens F, Herment A, Sidi D, et al. Increased central aortic stiffness and left ventricular mass in normotensive young subjects after successful coarctation repair. Am Heart J. 2008;155:187-93 pubmed
    Hypertension occurs in 20% to 40% of survivors of anatomically successful repair of aortic coarctation (CoA). The aim of the present study was to examine the role of central aortic function in this setting...
  16. Hassan W, Awad M, Fawzy M, Omrani A, Malik S, Akhras N, et al. Long-term effects of balloon angioplasty on left ventricular hypertrophy in adolescent and adult patients with native coarctation of the aorta. Up to 18 years follow-up results. Catheter Cardiovasc Interv. 2007;70:881-6 pubmed
    ..Little is known regarding the long-term follow-up results of balloon angioplasty (BA) for patients with native aortic coarctation (AC) on left ventricular hypertrophy (LVH) regression...
  17. Toro Salazar O, Steinberger J, Thomas W, Rocchini A, Carpenter B, Moller J. Long-term follow-up of patients after coarctation of the aorta repair. Am J Cardiol. 2002;89:541-7 pubmed
    ..More than 1/3 of the survivors developed significant late cardiovascular abnormalities. ..
  18. O Sullivan J, Derrick G, Darnell R. Prevalence of hypertension in children after early repair of coarctation of the aorta: a cohort study using casual and 24 hour blood pressure measurement. Heart. 2002;88:163-6 pubmed
  19. Moltzer E, Mattace Raso F, Karamermer Y, Boersma E, Webb G, Simoons M, et al. Comparison of Candesartan versus Metoprolol for treatment of systemic hypertension after repaired aortic coarctation. Am J Cardiol. 2010;105:217-22 pubmed publisher
    ..hypertension is one of the main determinants of cardiovascular morbidity and mortality in patients with aortic coarctation (CoA)...
  20. Schranz D, Zartner P, Michel Behnke I, Akinturk H. Bioabsorbable metal stents for percutaneous treatment of critical recoarctation of the aorta in a newborn. Catheter Cardiovasc Interv. 2006;67:671-3 pubmed
    In neonates and infants with critical aortic coarctation, balloon angioplasty is considered for rescue therapy of heart failure...
  21. Ho V, Bakalov V, Cooley M, Van P, Hood M, Burklow T, et al. Major vascular anomalies in Turner syndrome: prevalence and magnetic resonance angiographic features. Circulation. 2004;110:1694-700 pubmed
    Turner syndrome (TS) is associated with aortic coarctation and dissection; hence, echocardiographic evaluation of all patients is currently recommended...
  22. Loscalzo M, Van P, Ho V, Bakalov V, Rosing D, Malone C, et al. Association between fetal lymphedema and congenital cardiovascular defects in Turner syndrome. Pediatrics. 2005;115:732-5 pubmed associated with congenital cardiovascular defects (CCVDs), most commonly bicuspid aortic valve (BAV) and aortic coarctation (COARC), congenital renal anomalies, and fetal lymphedema...
  23. Heger M, Willfort A, Neunteufl T, Rosenhek R, Gabriel H, Wollenek G, et al. Vascular dysfunction after coarctation repair is related to the age at surgery. Int J Cardiol. 2005;99:295-9 pubmed
    Despite repair of aortic coarctation, hypertension is frequent in adults and premature coronary and cerebrovascular disease remain of concern...
  24. Iuliano L, Micheletta F, Natoli S, Tramaglino L, Greco C, Modesti P. Aortic coarctation in the elderly: how many errors lie behind an unexpected diagnosis?. Intern Emerg Med. 2007;2:207-9 pubmed
  25. Tzifa A, Ewert P, Brzezinska Rajszys G, Peters B, Zubrzycka M, Rosenthal E, et al. Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol. 2006;47:1457-63 pubmed
    This study sought to evaluate the use of covered Cheatham-platinum (CP) stents in the treatment of aortic coarctation (CoA). Aortic aneurysms and stent fractures have been encountered after surgical and transcatheter treatment for CoA...
  26. Murakami T, Takeda A. Enhanced aortic pressure wave reflection in patients after repair of aortic coarctation. Ann Thorac Surg. 2005;80:995-9 pubmed
  27. Forbes T, Moore P, Pedra C, Zahn E, Nykanen D, Amin Z, et al. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheter Cardiovasc Interv. 2007;70:569-77 pubmed
    ..We recommend IAI for all patients undergoing IS placement for treatment of CoA. ..
  28. Mullen M. Coarctation of the aorta in adults: do we need surgeons?. Heart. 2003;89:3-5 pubmed
  29. Yang B. Pseudocoarctation of the aorta with aneurysm formation: case report. Chin Med J (Engl). 2005;118:1230-2 pubmed
  30. Mivelaz Y, Di Bernardo S, Meijboom E, Sekarski N. Validation of two echocardiographic indexes to improve the diagnosis of complex coarctations. Eur J Cardiothorac Surg. 2008;34:1051-6 pubmed publisher
    ..5. The I/D ratio defined as the diameter of the isthmus to the diameter of the descending aorta, suggests an aortic coarctation when it is less than 0.64. This is a retrospective cohort study in a tertiary care children's hospital...
  31. Reich O, Tax P, Bartáková H, Tomek V, Gilík J, Lisy J, et al. Long-term (up to 20 years) results of percutaneous balloon angioplasty of recurrent aortic coarctation without use of stents. Eur Heart J. 2008;29:2042-8 pubmed publisher
    ..Angioplasty is safe and effective regardless of the type of surgery used and the recoarctation anatomy. Older age at the angioplasty is associated with a higher incidence of reinterventions. ..
  32. Walhout R, Lekkerkerker J, Oron G, Hitchcock F, Meijboom E, Bennink G. Comparison of polytetrafluoroethylene patch aortoplasty and end-to-end anastomosis for coarctation of the aorta. J Thorac Cardiovasc Surg. 2003;126:521-8 pubmed
    ..Polytetrafluoroethylene patch repair including coarctation ridge resection was found to be a risk factor for aneurysm formation and late hypertension. Arch hypoplasia and young age must be considered to predispose to recoarctation. ..
  33. Fedoruk L, Sett S, Murphy J, LeBlanc J, Patterson M. Compression of mediastinal structures treated by extra-anatomic bypass grafting. J Card Surg. 2004;19:343-5 pubmed
    ..Here we describe the use of an extra-anatomic bypass graft from the ascending to supraceliac aorta to treat an unusual complication of compression of mediastinal structures caused by a bucket handle graft. ..
  34. Hager A, Schreiber C, Nutzl S, Hess J. Mortality and restenosis rate of surgical coarctation repair in infancy: a study of 191 patients. Cardiology. 2009;112:36-41 pubmed publisher
    ..analyze mortality and the rate of restenosis in the follow-up of patients after surgical repair of isolated aortic coarctation in infancy. From 1974 to 2003, 191 patients underwent surgical repair of aortic coarctation in infancy...
  35. Bassareo P, Marras A, Manai M, Mercuro G. The influence of different surgical approaches on arterial rigidity in children after aortic coarctation repair. Pediatr Cardiol. 2009;30:414-8 pubmed publisher
    ..or secondary hypertension, probably related to the loss of arterial elasticity, frequently occur after aortic coarctation surgery...
  36. Unger E, Marsan R. Ruptured aneurysm 20 years after surgery for coarctation of the aorta. AJR Am J Roentgenol. 1977;129:329-30 pubmed
  37. Vriend J, Zwinderman A, de Groot E, Kastelein J, Bouma B, Mulder B. Predictive value of mild, residual descending aortic narrowing for blood pressure and vascular damage in patients after repair of aortic coarctation. Eur Heart J. 2005;26:84-90 pubmed
    ..mild residual descending aortic narrowing on blood pressure and vascular damage in patients after repair of aortic coarctation. In 107 consecutive post-coarctectomy patients, magnetic resonance imaging, ambulatory blood pressure ..
  38. Ou P, Mousseaux E, Celermajer D, Pedroni E, Vouhe P, Sidi D, et al. Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg. 2006;132:1105-11 pubmed
    ..This deformation of the aortic arch identifies a subgroup of subjects with postoperative coarctation at high risk of hypertension in young adult life. ..
  39. Zabal C, Attie F, Rosas M, Buendía Hernández A, García Montes J. The adult patient with native coarctation of the aorta: balloon angioplasty or primary stenting?. Heart. 2003;89:77-83 pubmed
    ..Mid term outcome in adult patients with native aortic coarctation receiving percutaneous treatment is strongly related to the immediate residual gradient...
  40. Secchi F, Iozzelli A, Papini G, Aliprandi A, Di Leo G, Sardanelli F. MR imaging of aortic coarctation. Radiol Med. 2009;114:524-37 pubmed publisher
    b>Aortic coarctation accounts for 5%-10% of all congenital heart diseases and represents 7% of critically ill infants with heart disease...
  41. Tan J, Babu Narayan S, Henein M, Mullen M, Li W. Doppler echocardiographic profile and indexes in the evaluation of aortic coarctation in patients before and after stenting. J Am Coll Cardiol. 2005;46:1045-53 pubmed
    We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients...
  42. Ou P, Celermajer D, Mousseaux E, Giron A, Aggoun Y, Szezepanski I, et al. Vascular remodeling after "successful" repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol. 2007;49:883-90 pubmed
    ..In young adult survivors of anatomically successful CoA repair, a gothic-type aortic arch with high H/W is associated with abnormal IMT, higher aortic stiffness index, and impaired arterial reactivity in the pre-CoA vasculature. ..
  43. Cleemann L, Mortensen K, Holm K, Smedegaard H, Skouby S, Wieslander S, et al. Aortic dimensions in girls and young women with turner syndrome: a magnetic resonance imaging study. Pediatr Cardiol. 2010;31:497-504 pubmed publisher
    ..60; all p < 0.04). The diameters of the aortic arch and the descending aorta correlated with a history of aortic coarctation (R = 0.35-0.52; p < 0.03)...
  44. Pandey R, Jackson M, Ajab S, Gladman G, Pozzi M. Subclavian flap repair: review of 399 patients at median follow-up of fourteen years. Ann Thorac Surg. 2006;81:1420-8 pubmed
    ..The overall incidence of hypertension is quite low. Patients remained normotensive when operated upon at the age of 0.9 months. The SFA, no doubt, effects the limb development; however it does not cause limitation in the lifestyle. ..
  45. Oliver J, Gallego P, Gonzalez A, Aroca A, Bret M, Mesa J. Risk factors for aortic complications in adults with coarctation of the aorta. J Am Coll Cardiol. 2004;44:1641-7 pubmed
    ..The only independent risk factors appear to be advanced age and bicuspid aortic valve. ..
  46. Sudarshan C, Cochrane A, Jun Z, Soto R, Brizard C. Repair of coarctation of the aorta in infants weighing less than 2 kilograms. Ann Thorac Surg. 2006;82:158-63 pubmed
    We retrospectively reviewed our experience in aortic coarctation repair on infants weighing less than 2 kg to evaluate the results and assess the rate of recoarctation in this group of patients...
  47. Rothman A, Galindo A, Evans W, Collazos J, Restrepo H. Effectiveness and safety of balloon dilation of native aortic coarctation in premature neonates weighing < or = 2,500 grams. Am J Cardiol. 2010;105:1176-80 pubmed publisher
    ..Some patients will have a successful long-term result after a single balloon dilation procedure. However, restenosis is common and tends to develop rapidly. ..
  48. Dodge Khatami A, Ott S, Di Bernardo S, Berger F. Carotid-subclavian artery index: new echocardiographic index to detect coarctation in neonates and infants. Ann Thorac Surg. 2005;80:1652-7 pubmed
  49. Nielsen J, Powell A, Gauvreau K, Marcus E, Prakash A, Geva T. Magnetic resonance imaging predictors of coarctation severity. Circulation. 2005;111:622-8 pubmed
    MRI is increasingly used for anatomic assessment of aortic coarctation (CoA), but its ability to predict the transcatheter pressure gradient, considered the reference standard for hemodynamic severity, has not been studied in detail...
  50. Chen S, Donald A, Storry C, Halcox J, Bonhoeffer P, Deanfield J. Impact of aortic stenting on peripheral vascular function and daytime systolic blood pressure in adult coarctation. Heart. 2008;94:919-24 pubmed
    ..Peripheral vascular dysfunction, however, remains unchanged and may contribute to residual hypertension. ..
  51. Kriaa S, Zbidi M, Hafsa C, Brahem R, Majdoub S, Golli M, et al. Tardus-parvus Doppler waveform in the renal arteries of an adult patient suggesting aortic coarctation. J Clin Ultrasound. 2006;34:458-60 pubmed
    ..Aortography confirmed a severe aortic coarctation. Because the typical signs and symptoms of aortic coarctation may not be present, especially in adults, a ..
  52. Meyer A, Joharchi M, Kundt G, Schuff Werner P, Steinhoff G, Kienast W. Predicting the risk of early atherosclerotic disease development in children after repair of aortic coarctation. Eur Heart J. 2005;26:617-22 pubmed
    Increased cardiovascular morbidity is manifested a long time after the repair of aortic coarctation (CoA)...
  53. Bentham J, Shettihalli N, Orchard E, Westaby S, Wilson N. Endovascular stent placement is an acceptable alternative to reoperation in selected infants with residual or recurrent aortic arch obstruction. Catheter Cardiovasc Interv. 2010;76:852-9 pubmed publisher
    ..Endovascular stent placement in infants is technically feasible with good results achievable even in small babies. It should be considered as a therapeutic option in complex cases when surgical alternatives are less favorable. ..