Materiały źródłowe

• #1 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #2 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  Coarctation of the aorta (CoA) accounts for approximately 5–8% of all congenital heart defects. […] Developments in diagnosis and management have improved outcomes in this patient population. Even after timely repair, it is important to regularly screen for hypertension. Patients with CoA require lifelong follow-up with a congenital heart disease specialist as these patients may develop recoarctation and complications at the repair site and remain at enhanced cardiovascular risk throughout their lifetime. […] Coarctation of the aorta (CoA) is one of the most common congenital heart defects (CHD), accounting for approximately 5–8% of CHD, with an incidence of 4 per 10,000 live births. […] There have been significant advances in the diagnosis and management of CoA with the advent of multi-modality imaging, rapid advances in interventional techniques and the accumulation of long-term data for patients who have been operated on in childhood.

• #3 Aortic Coarctation: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/150369-overview

  Coarctation of aorta represents 5%-8% of all congenital heart diseases, with the isolated form comprising 4%-6% of all congenital heart diseases. The prevalence of isolated forms is about 3-4 per 10,000 live births, and males are affected more frequently than females. […] Aortic coarctation is seven times more common in white persons than Asian persons. It has a lower incidence among Native Americans than other population groups in Minnesota. […] The male-to-female predominance is 1.3-2:1 in most series. […] The age at detection of coarctation of the aorta is dependent on the severity of the obstruction and the coexistence of other lesions.

• #4 Clinical manifestations and diagnosis of coarctation of the aorta – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-coarctation-of-the-aorta

  CoA accounts for 4 to 6 percent of all congenital heart defects with a reported prevalence of approximately 4 per 10,000 live births. It occurs more commonly in males than in females (59 versus 41 percent). Most cases are sporadic. […] Although CoA can rarely be acquired, the vast majority of CoA cases are congenital.

• #5 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  Coarctation of the aorta (CoA) accounts for approximately 5–8% of all congenital heart defects. […] Developments in diagnosis and management have improved outcomes in this patient population. Even after timely repair, it is important to regularly screen for hypertension. Patients with CoA require lifelong follow-up with a congenital heart disease specialist as these patients may develop recoarctation and complications at the repair site and remain at enhanced cardiovascular risk throughout their lifetime. […] Coarctation of the aorta (CoA) is one of the most common congenital heart defects (CHD), accounting for approximately 5–8% of CHD, with an incidence of 4 per 10,000 live births. […] There have been significant advances in the diagnosis and management of CoA with the advent of multi-modality imaging, rapid advances in interventional techniques and the accumulation of long-term data for patients who have been operated on in childhood.

• #6 Coarctation of the Aorta | Concise Medical Knowledge

  https://www.lecturio.com/concepts/coarctation-of-the-aorta/

  Coarctation of the aorta is typically congenital and the clinical presentation depends on the age of the patient. […] Incidence in the United States: 4 per 10,000 live births. […] Accounts for approximately 6% of all congenital heart disease. […] More common in boys (2:1 men:women ratio). […] Up to 15% of girls with coarctation of the aorta have Turner syndrome. […] Accompanied by bicuspid aortic valve in over 70% of cases. […] Close follow-up is required as the risk of hypertension and re-coarctation remain.

• #7 Coarctation of the Aorta (CoA) | Doctor

  https://patient.info/doctor/coarctation-of-the-aorta-pro

  There are no reliable figures for population incidence, estimated at 1 in 2,500 births. […] It is possibly more common in Caucasians and males. […] Affected parents have a higher risk of the abnormality affecting their child. […] Age at detection is determined by severity and whether there are other associated abnormalities.

• #8 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Coarctation of the aorta (CoA) is the fifth most common congenital heart defect, accounting for 68% of live births with congenital heart disease, with an estimated incidence of 1 in 2500 births. […] It affects more male babies than female, with a reported ratio in males of between 1.27:1 and 1.74:1. […] The presence of associated arch hypoplasia is relevant to longer term risk for the development of hypertension so in addition to re-coarctation, these patients are at increased risk for developing other comorbidities and should have lifelong follow up care. […] One genetic condition noted to be associated with an increased risk of having coarctation of the aorta (12-35%) is Turner syndrome. […] Lastly, the etiology of CoA is not well understood and thought to be affected by various factors including a genetic component, environmental factors, and arteriopathy.

• #9 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #10 Coarctation of the Aorta: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/895502-overview

  Coarctation of the aorta is a common defect and occurs in 6-8% of patients with congenital heart disease. […] The prevalence of coarctation of the aorta appears to be lower (2%) in Asian countries than in European and North American countries. […] No definitive racial differences have been documented in coarctation of the aorta, although some authors have suggested that coarctation of the aorta is less common in Asians. […] The male-to-female ratio is 2:1, although this ratio is not valid in abdominal coarctation of the aorta, in which this rare lesion predominantly affects females. […] Generally, patients with coarctation of the aorta present early in life with CHF or later in life with hypertension. Studies continue to document that coarctation of the aorta is often missed in the first year of life, and the median age of referral to a pediatric cardiologist in one study was 5 years.

• #11 Coarctation of the aorta | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/coarctation-of-the-aorta?lang=us

  Coarctations account for between 5-8% of all congenital heart defects. They are more frequent in males, M:F ratio of ~2-3:1. […] As with many congenital abnormalities, coarctation of the aorta is associated with other congenital anomalies.

• #12 Management of adults with coarctation of aorta

  https://www.wjgnet.com/1949-8462/full/v12/i5/167.htm

  Coarctation of the aorta (CoA) is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose. […] CoA accounts for 4%-6% of all congenital heart defects, with an incidence is of 3-4 cases per 10000 live births. […] Males are commonly affected than females with a ratio between 1.27:1 and 1.74:1, respectively. […] Early diagnosis and treatment are important as long-term data consistently demonstrate that patients with CoA have a reduced life expectancy and increased risk of cardiovascular complications. […] Persistent hypertension and vascular dysfunction can lead to an increased risk of coronary disease, which remains the greatest cause of long-term mortality. […] Thus, blood pressure control and periodic reassessment with transthoracic echocardiography and three-dimensional imaging (computed tomography or cardiac magnetic resonance) for should be performed regularly as cardiovascular complications may occur decades after the intervention.

• #13 Pathology and molecular mechanisms of coarctation of the aorta and its association with the ductus arteriosus | The Journal of Physiological Sciences | Full Text

  https://jps.biomedcentral.com/articles/10.1007/s12576-016-0512-x

  Coarctation of the aorta is the fifth or sixth most common congenital heart defect, accounting for 58% of neonates with congenital heart diseases. The incidence of CoA has been reported to one per 2500 births and the ratio of males to females with the condition to be between 1.27:1 and 1.74:1. In these studies, CoA was considered to be hemodynamically dominant in complex congenital heart defects with a left-to-right shunt. […] Early diagnosis and appropriate management of coarctation of the aorta (CoA) have resulted in a low mortality rate associated with the repair of CoA. It has been suggested that patients with CoA are at increased risk of myocardial infarction because systemic hypertension and premature atherosclerosis tend to develop early in life even after successful surgical treatment. The increased cardiovascular risk in this patient group is the result of both frequent relapses of hypertension and proatherogenic abnormalities that are present even in the absence of arterial hypertension. […] Accumulating evidence of vasoreactivity and endothelial function in patients with CoA suggests that CoA is not a simple mechanical obstruction that can be cured surgically.

• #14 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Coarctation of the aorta (CoA) is the fifth most common congenital heart defect, accounting for 68% of live births with congenital heart disease, with an estimated incidence of 1 in 2500 births. […] It affects more male babies than female, with a reported ratio in males of between 1.27:1 and 1.74:1. […] The presence of associated arch hypoplasia is relevant to longer term risk for the development of hypertension so in addition to re-coarctation, these patients are at increased risk for developing other comorbidities and should have lifelong follow up care. […] One genetic condition noted to be associated with an increased risk of having coarctation of the aorta (12-35%) is Turner syndrome. […] Lastly, the etiology of CoA is not well understood and thought to be affected by various factors including a genetic component, environmental factors, and arteriopathy.

• #15 Coarctation of the Aorta: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/895502-overview

  Coarctation of the aorta is a common defect and occurs in 6-8% of patients with congenital heart disease. […] The prevalence of coarctation of the aorta appears to be lower (2%) in Asian countries than in European and North American countries. […] No definitive racial differences have been documented in coarctation of the aorta, although some authors have suggested that coarctation of the aorta is less common in Asians. […] The male-to-female ratio is 2:1, although this ratio is not valid in abdominal coarctation of the aorta, in which this rare lesion predominantly affects females. […] Generally, patients with coarctation of the aorta present early in life with CHF or later in life with hypertension. Studies continue to document that coarctation of the aorta is often missed in the first year of life, and the median age of referral to a pediatric cardiologist in one study was 5 years.

• #16 Aortic Coarctation: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/150369-overview

  Coarctation of aorta represents 5%-8% of all congenital heart diseases, with the isolated form comprising 4%-6% of all congenital heart diseases. The prevalence of isolated forms is about 3-4 per 10,000 live births, and males are affected more frequently than females. […] Aortic coarctation is seven times more common in white persons than Asian persons. It has a lower incidence among Native Americans than other population groups in Minnesota. […] The male-to-female predominance is 1.3-2:1 in most series. […] The age at detection of coarctation of the aorta is dependent on the severity of the obstruction and the coexistence of other lesions.

• #17 Aortic coarctation epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Aortic_coarctation_epidemiology_and_demographics

  Coarctation of the aorta is a common congenital malformation. It occurs in about 7% of patients with congenital heart defects. It is more common in males than females with a ratio of 2:1. Up to 25% of patients with Turner syndrome have coarctation of the aorta. It is 7 times more common among caucasians than asians. […] Aortic coarctation is a common heart defect. It forms approximately 6-10% of all congenital heart disease cases. In live births, it accounts for approximately 5-7% of congenital heart disease in severely ill infants. […] The prevalence is lower in Asian countries compared to American and European countries.

• #18 Coarctation of the Aorta: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/895502-overview

  Coarctation of the aorta is a common defect and occurs in 6-8% of patients with congenital heart disease. […] The prevalence of coarctation of the aorta appears to be lower (2%) in Asian countries than in European and North American countries. […] No definitive racial differences have been documented in coarctation of the aorta, although some authors have suggested that coarctation of the aorta is less common in Asians. […] The male-to-female ratio is 2:1, although this ratio is not valid in abdominal coarctation of the aorta, in which this rare lesion predominantly affects females. […] Generally, patients with coarctation of the aorta present early in life with CHF or later in life with hypertension. Studies continue to document that coarctation of the aorta is often missed in the first year of life, and the median age of referral to a pediatric cardiologist in one study was 5 years.

• #19 Aortic coarctation epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Aortic_coarctation_epidemiology_and_demographics

  Coarctation of the aorta is a common congenital malformation. It occurs in about 7% of patients with congenital heart defects. It is more common in males than females with a ratio of 2:1. Up to 25% of patients with Turner syndrome have coarctation of the aorta. It is 7 times more common among caucasians than asians. […] Aortic coarctation is a common heart defect. It forms approximately 6-10% of all congenital heart disease cases. In live births, it accounts for approximately 5-7% of congenital heart disease in severely ill infants. […] The prevalence is lower in Asian countries compared to American and European countries.

• #20 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #21 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Coarctation of the aorta (CoA) is the fifth most common congenital heart defect, accounting for 68% of live births with congenital heart disease, with an estimated incidence of 1 in 2500 births. […] It affects more male babies than female, with a reported ratio in males of between 1.27:1 and 1.74:1. […] The presence of associated arch hypoplasia is relevant to longer term risk for the development of hypertension so in addition to re-coarctation, these patients are at increased risk for developing other comorbidities and should have lifelong follow up care. […] One genetic condition noted to be associated with an increased risk of having coarctation of the aorta (12-35%) is Turner syndrome. […] Lastly, the etiology of CoA is not well understood and thought to be affected by various factors including a genetic component, environmental factors, and arteriopathy.

• #22 Coarctation of the Aorta | Concise Medical Knowledge

  https://www.lecturio.com/concepts/coarctation-of-the-aorta/

  Coarctation of the aorta is typically congenital and the clinical presentation depends on the age of the patient. […] Incidence in the United States: 4 per 10,000 live births. […] Accounts for approximately 6% of all congenital heart disease. […] More common in boys (2:1 men:women ratio). […] Up to 15% of girls with coarctation of the aorta have Turner syndrome. […] Accompanied by bicuspid aortic valve in over 70% of cases. […] Close follow-up is required as the risk of hypertension and re-coarctation remain.

• #23 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #24 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #25 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/chd/coarctation-aorta

  Coarctation is found in 6% to 8% of patients with congenital heart disease. Associated anomalies include bicuspid aortic valve, ventricular septal defect, small left sided structures (also known as Shones variant/complex) as well as variants of single ventricle anatomy. Coarctation of the aorta also accounts for a small percentage of children diagnosed later in life who present with systemic hypertension. […] There is an increased prevalence of coarctation in various genetic syndromes such as Turners syndrome (XO), Williams Syndrome, Noonan Syndrome, Rubenstein-Taybi syndrome, Alagille Syndrome, Neurofibromatosis, Kabuki Syndrome and PHACES syndrome. There is a slight male predominance. Offspring and other first-degree relatives diagnosed with an obstructive left-sided cardiac lesion are at ten times the risk of coarctation and other cardiac lesions.

• #26 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Epidemiological studies have found that for left ventricular outflow tract lesions, there is a higher chance of concordant diagnosis in multiple family members. […] All patients with coarctation (repaired or not) should be monitored with lifelong congenital cardiology follow-up and imaging because long-term survival is reduced compared with normative populations and there is potential need for reintervention. […] The unoperated mean survival rate of adults with coarctation of the aorta is 35 years of age, with a mortality rate of 75% by 46 years of age. […] In general, the patients with CoA who are repaired at a later age are more likely to remain hypertensive. […] The 2015 scientific statement of the AHA/ACC provides competitive athletic participation guidelines for patients with congenital heart disease (CHD), including coarctation.

• #27 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/chd/coarctation-aorta

  Coarctation is found in 6% to 8% of patients with congenital heart disease. Associated anomalies include bicuspid aortic valve, ventricular septal defect, small left sided structures (also known as Shones variant/complex) as well as variants of single ventricle anatomy. Coarctation of the aorta also accounts for a small percentage of children diagnosed later in life who present with systemic hypertension. […] There is an increased prevalence of coarctation in various genetic syndromes such as Turners syndrome (XO), Williams Syndrome, Noonan Syndrome, Rubenstein-Taybi syndrome, Alagille Syndrome, Neurofibromatosis, Kabuki Syndrome and PHACES syndrome. There is a slight male predominance. Offspring and other first-degree relatives diagnosed with an obstructive left-sided cardiac lesion are at ten times the risk of coarctation and other cardiac lesions.

• #28 Coarctation of the Aorta | Concise Medical Knowledge

  https://www.lecturio.com/concepts/coarctation-of-the-aorta/

  Coarctation of the aorta is typically congenital and the clinical presentation depends on the age of the patient. […] Incidence in the United States: 4 per 10,000 live births. […] Accounts for approximately 6% of all congenital heart disease. […] More common in boys (2:1 men:women ratio). […] Up to 15% of girls with coarctation of the aorta have Turner syndrome. […] Accompanied by bicuspid aortic valve in over 70% of cases. […] Close follow-up is required as the risk of hypertension and re-coarctation remain.

• #29 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/chd/coarctation-aorta

  Coarctation is found in 6% to 8% of patients with congenital heart disease. Associated anomalies include bicuspid aortic valve, ventricular septal defect, small left sided structures (also known as Shones variant/complex) as well as variants of single ventricle anatomy. Coarctation of the aorta also accounts for a small percentage of children diagnosed later in life who present with systemic hypertension. […] There is an increased prevalence of coarctation in various genetic syndromes such as Turners syndrome (XO), Williams Syndrome, Noonan Syndrome, Rubenstein-Taybi syndrome, Alagille Syndrome, Neurofibromatosis, Kabuki Syndrome and PHACES syndrome. There is a slight male predominance. Offspring and other first-degree relatives diagnosed with an obstructive left-sided cardiac lesion are at ten times the risk of coarctation and other cardiac lesions.

• #30 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Coarctation of the aorta (CoA) is the fifth most common congenital heart defect, accounting for 68% of live births with congenital heart disease, with an estimated incidence of 1 in 2500 births. […] It affects more male babies than female, with a reported ratio in males of between 1.27:1 and 1.74:1. […] The presence of associated arch hypoplasia is relevant to longer term risk for the development of hypertension so in addition to re-coarctation, these patients are at increased risk for developing other comorbidities and should have lifelong follow up care. […] One genetic condition noted to be associated with an increased risk of having coarctation of the aorta (12-35%) is Turner syndrome. […] Lastly, the etiology of CoA is not well understood and thought to be affected by various factors including a genetic component, environmental factors, and arteriopathy.

• #31 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. […] A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings. […] The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis.

• #32 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patient’s lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist. […] CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings.

• #33 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis. […] Studies analysing the performance of fetal echocardiography in the prenatal diagnosis of CoA have found that multiparametric models have a superior diagnostic performance to any one quantitative echocardiographic measure. […] CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. Histologically, this is characterised by myocyte hypertrophy, disarray and fibrosis. Ensuing alteration in myocardial mechanical properties manifests in the form of diastolic and systolic dysfunction, with LV failure being a significant cause of mortality. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease.

• #34 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189?type=check_update&version=2

  The development of coordinated care for patients with adult congenital heart disease in the developed world has also led to improvements in outcomes. […] There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patient’s lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist. […] CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings.

• #35 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis. […] Studies analysing the performance of fetal echocardiography in the prenatal diagnosis of CoA have found that multiparametric models have a superior diagnostic performance to any one quantitative echocardiographic measure. […] CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. Histologically, this is characterised by myocyte hypertrophy, disarray and fibrosis. Ensuing alteration in myocardial mechanical properties manifests in the form of diastolic and systolic dysfunction, with LV failure being a significant cause of mortality. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease.

• #36 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/fetal/fetal-coa

  Prevalence of ~4 per 10 000 live births. […] Depending on the gestational age at the time of initial suspicion, fetal echocardiograms may be performed every 46 weeks, with the last evaluation obtained after 30 weeks. At the very least, one follow-up evaluation in the third trimester is reasonable to assess for progression of abnormalities and to detect those that may not have been evident on the initial scan. An important echocardiographic predictor for CoA is progression in the degree of hypoplasia of the LV and aortic dimensions during serial evaluations. […] Surveillance should include assessment of left heart growth (LV, mitral valve, aortic valve, aortic arch) with careful attention paid to detailed quantification of aortic dimensions and Doppler assessment of the left heart and aortic arch. This will assist the clinician to more reasonably predict postnatal expectations and whether or not PGE would be required postnatally.

• #37 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/fetal/fetal-coa

  Coarctation of the aorta (CoA) is a narrowing of the aortic arch. It most commonly occurs in the region of the aortic isthmus (between the left subclavian artery and ductus arteriosus). Patients with a severe coarctation of the aorta are dependent on a patent ductus arteriosus (PDA) to preserve systemic blood flow and perfusion. CoA has a variable spectrum of severity, ranging from unequivocal ductal-dependent systemic blood flow, to patients with borderline small arch dimensions who also have a PDA. […] The sensitivity of fetal diagnosis of CoA varies from 50% to 72%, and delayed diagnosis of CoA is still common. Infants who elude prenatal or early neonatal diagnosis may present in cardiogenic shock that may be associated with profound ventricular dysfunction. […] 4%6% of all CHD in the United States

• #38 Coarctation of the Aorta | Pediatric Echocardiography

  https://pedecho.org/library/fetal/fetal-coa

  Coarctation of the aorta (CoA) is a narrowing of the aortic arch. It most commonly occurs in the region of the aortic isthmus (between the left subclavian artery and ductus arteriosus). Patients with a severe coarctation of the aorta are dependent on a patent ductus arteriosus (PDA) to preserve systemic blood flow and perfusion. CoA has a variable spectrum of severity, ranging from unequivocal ductal-dependent systemic blood flow, to patients with borderline small arch dimensions who also have a PDA. […] The sensitivity of fetal diagnosis of CoA varies from 50% to 72%, and delayed diagnosis of CoA is still common. Infants who elude prenatal or early neonatal diagnosis may present in cardiogenic shock that may be associated with profound ventricular dysfunction. […] 4%6% of all CHD in the United States

• #39 Prevalence of aortic coarctation in Bogotá-Colombia from 2001 to 2018. The diagnostic needs to improve

  https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-99402022000200196&lng=en&nrm=iso&tlng=en

  The best way to screen patients for congenital heart disease is pulse oximetry 24-48 h after birth. […] It is important to mention that using pulse oximetry as a screening method has a sensitivity of 80% and that false negative oximeter results are not rare. […] The current study found a higher prevalence for aortic coarctation in Bogot in comparison with the study conducted by Tassinari et al. that worked with the same surveillance program: Surveillance and Follow-up Program for Children with Congenital Anomalies of the Health Secretary of Bogot. […] However, the prevalence found in Bogot is still lower compared to prevalence worldwide and in other continents. Furthermore, the prevalence found in Latinamerica was significantly lower compared to prevalence in Asia, Europe, and The United States. […] As a result of the information previously mentioned, we emphasize the importance of standardizing screening techniques in a local scale, as well as in a continental scale, so that every hospital can apply them, and no newborn is discharged without a diagnosis and a proper notification.

• #40 Prevalence of aortic coarctation in Bogotá-Colombia from 2001 to 2018. The diagnostic needs to improve

  https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-99402022000200196&lng=en&nrm=iso&tlng=en

  The best way to screen patients for congenital heart disease is pulse oximetry 24-48 h after birth. […] It is important to mention that using pulse oximetry as a screening method has a sensitivity of 80% and that false negative oximeter results are not rare. […] The current study found a higher prevalence for aortic coarctation in Bogot in comparison with the study conducted by Tassinari et al. that worked with the same surveillance program: Surveillance and Follow-up Program for Children with Congenital Anomalies of the Health Secretary of Bogot. […] However, the prevalence found in Bogot is still lower compared to prevalence worldwide and in other continents. Furthermore, the prevalence found in Latinamerica was significantly lower compared to prevalence in Asia, Europe, and The United States. […] As a result of the information previously mentioned, we emphasize the importance of standardizing screening techniques in a local scale, as well as in a continental scale, so that every hospital can apply them, and no newborn is discharged without a diagnosis and a proper notification.

• #41 Coarctation of the aorta: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000191.htm

  Aortic coarctation is one of the more common heart conditions that are present at birth (congenital heart defects). This abnormality accounts for about 5% of all congenital heart defects. It is most often diagnosed in children or adults under age 40. […] Coarctation is often discovered during a newborn’s first exam or a well-baby exam. Taking the pulse in an infant is an important part of the exam, because there may not be any other symptoms until the child is older. […] Without treatment, most people die before age 40. For this reason, doctors most often recommend that the person has surgery before age 10. Most of the time, surgery to fix the coarctation is done during infancy. […] Lifelong follow-up with a cardiologist is recommended.

• #42 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. […] A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings. […] The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis.

• #43 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patient’s lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist. […] CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings.

• #44 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. […] A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings. […] The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis.

• #45 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patient’s lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist. […] CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings.

• #46 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Older children with repaired coarctation of the aorta (CoA) with mild or no residual lesions may be followed less frequently (up to every 2 years) with echocardiography. […] Cardiac computed tomography and cardiac magnetic resonance imaging are useful adjuncts to echocardiography in the serial evaluation of older children and adults with repaired CoA. […] After CoA repair, patients should be monitored for systemic and masked hypertension. […] However, evidence-based guidelines for the care of these patients are lacking and significant practice variation exists. […] The goal of the congenital heart disease (CHD) Clinical Practice Algorithm for Repaired CoA is to provide an age-based decision-support tool that can be used in the follow-up and surveillance of patients with isolated repaired CoA throughout their lifespans.

• #47 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Each pathway provides a suggested guide to the frequency of clinic visits and type of testing, with younger age and greater-than-mild residual lesions meriting closer follow-up. […] Patients with repaired CoA can continue to have or develop new hypertension even after early repair and with optimal surgical results. […] The Quality Working Group of the American College of Cardiology (ACC) Adult Congenital and Pediatric Cardiology (ACPC) member section incorporated assessment and counseling for CV risk factors into the clinical algorithm based on current evidence for risk of vascular dysfunction in CoA. […] By using this tool, a standard approach for frequency of follow-up and testing, including echocardiography and cross-sectional imaging, for patients with isolated repaired CoA from birth to adulthood may be achieved.

• #48 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Older children with repaired coarctation of the aorta (CoA) with mild or no residual lesions may be followed less frequently (up to every 2 years) with echocardiography. […] Cardiac computed tomography and cardiac magnetic resonance imaging are useful adjuncts to echocardiography in the serial evaluation of older children and adults with repaired CoA. […] After CoA repair, patients should be monitored for systemic and masked hypertension. […] However, evidence-based guidelines for the care of these patients are lacking and significant practice variation exists. […] The goal of the congenital heart disease (CHD) Clinical Practice Algorithm for Repaired CoA is to provide an age-based decision-support tool that can be used in the follow-up and surveillance of patients with isolated repaired CoA throughout their lifespans.

• #49 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Older children with repaired coarctation of the aorta (CoA) with mild or no residual lesions may be followed less frequently (up to every 2 years) with echocardiography. […] Cardiac computed tomography and cardiac magnetic resonance imaging are useful adjuncts to echocardiography in the serial evaluation of older children and adults with repaired CoA. […] After CoA repair, patients should be monitored for systemic and masked hypertension. […] However, evidence-based guidelines for the care of these patients are lacking and significant practice variation exists. […] The goal of the congenital heart disease (CHD) Clinical Practice Algorithm for Repaired CoA is to provide an age-based decision-support tool that can be used in the follow-up and surveillance of patients with isolated repaired CoA throughout their lifespans.

• #50 Aortic coarctation in a 49-year-old female | British Columbia Medical Journal

  https://bcmj.org/articles/aortic-coarctation-49-year-old-female

  Undiagnosed adults are commonly hypertensive but otherwise asymptomatic, unless significant hypertension exists, in which case, headache, epistaxis, heart failure, aortic dissection, or lower extremity claudication can be present. […] Current guidelines recommend that every patient with AC, repaired or not, should have at least one cardiovascular MRI or CT scan to determine the location and severity of coarctation as well as to evaluate collateral flow. […] A recent Cochrane review performed by Padua and colleagues evaluated several studies comparing endovascular stenting and surgical repair in the treatment of aortic coarctation. They concluded that there is insufficient evidence to determine the best treatment for coarctation of the thoracic aorta and emphasized the need for a randomized controlled clinical trial with high-quality samples and long-term follow-up. […] Although uncommon in adults, aortic coarctation can have significant mortality and should be included in the differential diagnosis for difficult-to-control hypertension.

• #51 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Older children with repaired coarctation of the aorta (CoA) with mild or no residual lesions may be followed less frequently (up to every 2 years) with echocardiography. […] Cardiac computed tomography and cardiac magnetic resonance imaging are useful adjuncts to echocardiography in the serial evaluation of older children and adults with repaired CoA. […] After CoA repair, patients should be monitored for systemic and masked hypertension. […] However, evidence-based guidelines for the care of these patients are lacking and significant practice variation exists. […] The goal of the congenital heart disease (CHD) Clinical Practice Algorithm for Repaired CoA is to provide an age-based decision-support tool that can be used in the follow-up and surveillance of patients with isolated repaired CoA throughout their lifespans.

• #52 Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/16/17/09/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Repaired-Coarctation-of-the-Aorta

  Each pathway provides a suggested guide to the frequency of clinic visits and type of testing, with younger age and greater-than-mild residual lesions meriting closer follow-up. […] Patients with repaired CoA can continue to have or develop new hypertension even after early repair and with optimal surgical results. […] The Quality Working Group of the American College of Cardiology (ACC) Adult Congenital and Pediatric Cardiology (ACPC) member section incorporated assessment and counseling for CV risk factors into the clinical algorithm based on current evidence for risk of vascular dysfunction in CoA. […] By using this tool, a standard approach for frequency of follow-up and testing, including echocardiography and cross-sectional imaging, for patients with isolated repaired CoA from birth to adulthood may be achieved.

• #53 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease. […] Hypertension remains a key risk factor for adverse cardiovascular outcomes.

• #54 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis. […] Studies analysing the performance of fetal echocardiography in the prenatal diagnosis of CoA have found that multiparametric models have a superior diagnostic performance to any one quantitative echocardiographic measure. […] CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. Histologically, this is characterised by myocyte hypertrophy, disarray and fibrosis. Ensuing alteration in myocardial mechanical properties manifests in the form of diastolic and systolic dysfunction, with LV failure being a significant cause of mortality. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease.

• #55 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease. […] Hypertension remains a key risk factor for adverse cardiovascular outcomes.

• #56 Coarctation of the Aorta – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430913/

  Coarctation of the aorta is a relatively common congenital heart defect, accounting for approximately 5% to 7% of all congenital heart diseases and occurring more frequently in males, with a male-to-female ratio of about 2:1. […] The epidemiology of aortic coarctation also reveals a significant genetic component. Turner syndrome is strongly associated with coarctation of the aorta, leading to an increased risk of left-sided obstructive heart lesions; karyotype screening is recommended for females diagnosed with aortic coarctation. Additionally, first-degree relatives of individuals with obstructive left-sided heart lesions have a 10-fold increased risk of developing aortic coarctation and other congenital heart defects. […] Despite advancements in early detection and treatment, coarctation of the aorta remains a significant contributor to cardiovascular morbidity and mortality, particularly when associated with other congenital anomalies.

• #57 Case series: surgery for complications following aortic coarctation repair – Olayiwola – Journal of Visualized Surgery

  https://jovs.amegroups.org/article/view/119140/html

  Coarctation of the aorta (CoA) accounts for 57% of congenital heart defects with an incidence of 0.3/1,000 births. […] Long-term complications include re-stenosis and aneurysm formation, with a life-time risk between 138% depending on the primary type of repair. […] Lifelong surveillance with adequate imaging intervals may allow early identification of complications and planning for elective surgery. […] Referral to a specialised aortic centre for surveillance and expedited treatment is paramount for success. […] We suggest a more frequent follow-up protocol with agreed imaging interval for these patients. […] A more frequent imaging interval than the currently suggested by the guidelines is advised for those repaired in the adult life to be able to identify these cases before devastating consequences. […] Given the high rate and life-threatening nature of late complications, the need for life-long follow-up cannot be over-emphasized; however, this is not always available or adequate.

• #58 SciELO Brazil – Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital

  https://www.scielo.br/j/ijcs/a/ZTDr6Rj4z7xPDzqrFW8fFmw/?lang=en

  Coarctation of the aorta is a congenital segmental narrowing of the aortic arch with severe hemodynamic repercussions and increased cardiovascular mortality. […] However, this goal has been challenged by high rates of underdiagnosis, which delay surgical correction, and by recoarctation in up to one third of operated patients. […] Recoarctation occurs in one-third of patients and draws attention for the need of lifelong surveillance by echocardiography. […] Late correction frequently occurs as a result of an underdiagnosis rate of over 62%, placing CoA as the most frequently misdiagnosed critical congenital heart disease. […] This complication demands a life-long surveillance by regular echocardiography in repaired patients. […] Our study found a high prevalence of LV hypertrophy at baseline, which markedly decreased after surgical correction.

• #59 SciELO Brazil – Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital

  https://www.scielo.br/j/ijcs/a/ZTDr6Rj4z7xPDzqrFW8fFmw/?lang=en

  Importantly, these features are not prevented by surgical correction, reinforcing that coarctation is a generalized vasculopathy far beyond the narrowing of the aortic arch. […] In our study, recoarctation had a negative impact on the benefit of surgery in one-third of patients, which reinforces the need for lifelong surveillance by echocardiography.

• #60 Coarctation of the aorta: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000191.htm

  Aortic coarctation is one of the more common heart conditions that are present at birth (congenital heart defects). This abnormality accounts for about 5% of all congenital heart defects. It is most often diagnosed in children or adults under age 40. […] Coarctation is often discovered during a newborn’s first exam or a well-baby exam. Taking the pulse in an infant is an important part of the exam, because there may not be any other symptoms until the child is older. […] Without treatment, most people die before age 40. For this reason, doctors most often recommend that the person has surgery before age 10. Most of the time, surgery to fix the coarctation is done during infancy. […] Lifelong follow-up with a cardiologist is recommended.

• #61 Aortic coarctation in a 49-year-old female | British Columbia Medical Journal

  https://bcmj.org/articles/aortic-coarctation-49-year-old-female

  Aortic coarctation is characterized by localized narrowing of the thoracic aorta. While it is frequently diagnosed in infancy and childhood, first-time presentations in adults are rare. Unless significant hypertension exists, adult patients are usually asymptomatic. When aortic coarctation is not detected and repaired, survival averages 35 years, with mortality increasing to 75% by age 46. […] Although rarely diagnosed in adults, narrowing of the thoracic artery should be considered when patients present with difficult-to-control hypertension. […] Most cases are congenital and occur in about 4 of 10 000 live births. Diagnosis is most often made during infancy and childhood, and only rarely in adulthood. […] When aortic coarctation is not detected and repaired, survival averages 35 years, with mortality increasing to 75% by age 46. In addition to systemic hypertension, common complications of untreated AC include expedited coronary artery disease, stroke, aortic dissection, and heart failure.

• #62 The Adult with Coarctation of the Aorta | IntechOpen

  https://www.intechopen.com/chapters/64223

  Epidemiological studies have found that for left ventricular outflow tract lesions, there is a higher chance of concordant diagnosis in multiple family members. […] All patients with coarctation (repaired or not) should be monitored with lifelong congenital cardiology follow-up and imaging because long-term survival is reduced compared with normative populations and there is potential need for reintervention. […] The unoperated mean survival rate of adults with coarctation of the aorta is 35 years of age, with a mortality rate of 75% by 46 years of age. […] In general, the patients with CoA who are repaired at a later age are more likely to remain hypertensive. […] The 2015 scientific statement of the AHA/ACC provides competitive athletic participation guidelines for patients with congenital heart disease (CHD), including coarctation.

• #63 The Polls Are In: Head Imaging in Patients with Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2020/11/23/14/54/The-Polls-Are-In-Head-Imaging-in-Patients-with-Coarctation-of-the-Aorta

  Intracranial aneurysms (ICAs) occur in patients with Coarctation of the Aorta (CoA), putting them at risk for stroke. […] Recommendations to screen for the presence of ICAs are variable. […] There may be some modifiable risk factors, such as long-standing hypertension, that may increase the risk for the development of ICAs in patients with CoA. […] The 2018 ACC/AHA guidelines for the care of the adult with congenital heart disease (CHD) suggest that screening for ICAs by magnetic resonance angiography (MRA) or computed tomography angiography (CTA) may be reasonable in adults with CoA (COR IIb, LOE B-NR). […] In contrast, routine imaging to assess for ICAs in asymptomatic patients with CoA was not recommended in the 2020 ESC Guidelines. […] In the pediatric age group, screening practices are likewise variable and inconsistent.

• #64 The Polls Are In: Head Imaging in Patients with Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2020/11/23/14/54/The-Polls-Are-In-Head-Imaging-in-Patients-with-Coarctation-of-the-Aorta

  This poll evaluated the customary approach to imaging surveillance for ICAs in patients with CoA. […] ICAs have a higher incidence in older patients with CoA. […] Compared to the general population, these adult patients suffer from both ischemic and hemorrhagic stroke at significantly younger ages. […] On the other hand, children with CoA who are treated early in life appear to not have a higher incidence of ICAs. […] This may question the previously held belief of a developmental relationship between CoA and ICAs, as well as the value of screening for cerebral vascular anomalies in infants and young children with isolated disease. […] This may also suggest that there are perhaps some modifiable risk factors, such as long-standing hypertension, that may be responsible for the development of ICAs in patients with CoA who are diagnosed and treated in later adulthood.

• #65 The Polls Are In: Head Imaging in Patients with Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2020/11/23/14/54/The-Polls-Are-In-Head-Imaging-in-Patients-with-Coarctation-of-the-Aorta

  Intracranial aneurysms (ICAs) occur in patients with Coarctation of the Aorta (CoA), putting them at risk for stroke. […] Recommendations to screen for the presence of ICAs are variable. […] There may be some modifiable risk factors, such as long-standing hypertension, that may increase the risk for the development of ICAs in patients with CoA. […] The 2018 ACC/AHA guidelines for the care of the adult with congenital heart disease (CHD) suggest that screening for ICAs by magnetic resonance angiography (MRA) or computed tomography angiography (CTA) may be reasonable in adults with CoA (COR IIb, LOE B-NR). […] In contrast, routine imaging to assess for ICAs in asymptomatic patients with CoA was not recommended in the 2020 ESC Guidelines. […] In the pediatric age group, screening practices are likewise variable and inconsistent.

• #66 The Polls Are In: Head Imaging in Patients with Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2020/11/23/14/54/The-Polls-Are-In-Head-Imaging-in-Patients-with-Coarctation-of-the-Aorta

  This poll evaluated the customary approach to imaging surveillance for ICAs in patients with CoA. […] ICAs have a higher incidence in older patients with CoA. […] Compared to the general population, these adult patients suffer from both ischemic and hemorrhagic stroke at significantly younger ages. […] On the other hand, children with CoA who are treated early in life appear to not have a higher incidence of ICAs. […] This may question the previously held belief of a developmental relationship between CoA and ICAs, as well as the value of screening for cerebral vascular anomalies in infants and young children with isolated disease. […] This may also suggest that there are perhaps some modifiable risk factors, such as long-standing hypertension, that may be responsible for the development of ICAs in patients with CoA who are diagnosed and treated in later adulthood.

• #67 The Polls Are In: Head Imaging in Patients with Coarctation of the Aorta

  https://www.acc.org/Latest-in-Cardiology/Articles/2020/11/23/14/54/The-Polls-Are-In-Head-Imaging-in-Patients-with-Coarctation-of-the-Aorta

  This poll evaluated the customary approach to imaging surveillance for ICAs in patients with CoA. […] ICAs have a higher incidence in older patients with CoA. […] Compared to the general population, these adult patients suffer from both ischemic and hemorrhagic stroke at significantly younger ages. […] On the other hand, children with CoA who are treated early in life appear to not have a higher incidence of ICAs. […] This may question the previously held belief of a developmental relationship between CoA and ICAs, as well as the value of screening for cerebral vascular anomalies in infants and young children with isolated disease. […] This may also suggest that there are perhaps some modifiable risk factors, such as long-standing hypertension, that may be responsible for the development of ICAs in patients with CoA who are diagnosed and treated in later adulthood.

• #68 Coarctation of the Aorta: Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10340190/

  Coarctation of the aorta (CoA) accounts for approximately 58% of all congenital heart defects. […] Developments in diagnosis and management have improved outcomes in this patient population. […] Even after timely repair, it is important to regularly screen for hypertension. Patients with CoA require lifelong follow-up with a congenital heart disease specialist as these patients may develop recoarctation and complications at the repair site and remain at enhanced cardiovascular risk throughout their lifetime. […] Coarctation of the aorta (CoA) is one of the most common congenital heart defects (CHD), accounting for approximately 58% of CHD, with an incidence of 4 per 10,000 live births. […] There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patients lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist.

• #69 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189

  There is increasing evidence that CoA represents a generalised arteriopathy, leading to an enhanced cardiovascular risk across the patient’s lifetime and the need for lifelong follow-up with an adult congenital heart disease specialist. […] CoA represents a lifelong condition. Even after an apparently successful repair in infancy, there is a high rate of reoperation, reported to be around 50% by the fifth decade. A decreased life expectancy has been shown in long-term follow-up data of repaired CoA patients when compared to the general population, with a high rate of adverse cardiovascular events. […] Prenatal diagnosis of CoA is notoriously challenging, with a high rate of false positives on pulse oximetry and fetal echocardiography-based screening, leading to considerable anxiety for families and allocation of limited paediatric and neonatal resources to the admission and surveillance of neonates with equivocal findings.

• #70 Coarctation of the Aorta – ACHA

  https://www.achaheart.org/your-heart/educational-qas/types-of-heart-defects/coarctation-of-the-aorta/

  Most women with repaired coarctation can have successful pregnancies. […] About 15-20% of women with coarctation have high blood pressure during pregnancy. […] We used to think that coarctation was a simple defect. But we now realize that it is much more than a narrowed aorta. […] Coarctation of the aorta is a lifelong disorder. But the good news is that most people with coarctation continue to do well.

• #71 Pathology and molecular mechanisms of coarctation of the aorta and its association with the ductus arteriosus | The Journal of Physiological Sciences | Full Text

  https://jps.biomedcentral.com/articles/10.1007/s12576-016-0512-x

  Coarctation of the aorta is the fifth or sixth most common congenital heart defect, accounting for 58% of neonates with congenital heart diseases. The incidence of CoA has been reported to one per 2500 births and the ratio of males to females with the condition to be between 1.27:1 and 1.74:1. In these studies, CoA was considered to be hemodynamically dominant in complex congenital heart defects with a left-to-right shunt. […] Early diagnosis and appropriate management of coarctation of the aorta (CoA) have resulted in a low mortality rate associated with the repair of CoA. It has been suggested that patients with CoA are at increased risk of myocardial infarction because systemic hypertension and premature atherosclerosis tend to develop early in life even after successful surgical treatment. The increased cardiovascular risk in this patient group is the result of both frequent relapses of hypertension and proatherogenic abnormalities that are present even in the absence of arterial hypertension. […] Accumulating evidence of vasoreactivity and endothelial function in patients with CoA suggests that CoA is not a simple mechanical obstruction that can be cured surgically.

• #72 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189?type=check_update&version=2

  The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis. […] Studies analysing the performance of fetal echocardiography in the prenatal diagnosis of CoA have found that multiparametric models have a superior diagnostic performance to any one quantitative echocardiographic measure. […] CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. Histologically, this is characterised by myocyte hypertrophy, disarray and fibrosis. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease. […] CoA remains a diagnostic and therapeutic challenge due to the difficulties of prenatal diagnosis, wide-ranging anatomical variation, long-term adverse cardiovascular sequelae of abnormal haemodynamics and impaired systemic vascular function, which are still not fully understood. Even where there is timely repair, these patients remain at enhanced cardiovascular risk throughout their lifetime.

• #73 Coarctation of the Aorta: Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/13/2189?type=check_update&version=2

  The majority of true CoA cases are missed prenatally, and therefore clinicians rightly have a low threshold for enhancing surveillance of those with a suspicion of this diagnosis. […] Studies analysing the performance of fetal echocardiography in the prenatal diagnosis of CoA have found that multiparametric models have a superior diagnostic performance to any one quantitative echocardiographic measure. […] CoA leads to pressure overload of the left ventricle and adverse left ventricular remodelling. Histologically, this is characterised by myocyte hypertrophy, disarray and fibrosis. […] Even after complete relief of obstruction, CoA is associated with diastolic dysfunction independent of the presence of coronary artery disease. […] CoA remains a diagnostic and therapeutic challenge due to the difficulties of prenatal diagnosis, wide-ranging anatomical variation, long-term adverse cardiovascular sequelae of abnormal haemodynamics and impaired systemic vascular function, which are still not fully understood. Even where there is timely repair, these patients remain at enhanced cardiovascular risk throughout their lifetime.

• #74 SciELO Brazil – Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital Coarctation of The Aorta: A Case-Series from a Tertiary Care Hospital

  https://www.scielo.br/j/ijcs/a/ZTDr6Rj4z7xPDzqrFW8fFmw/?lang=en

  Importantly, these features are not prevented by surgical correction, reinforcing that coarctation is a generalized vasculopathy far beyond the narrowing of the aortic arch. […] In our study, recoarctation had a negative impact on the benefit of surgery in one-third of patients, which reinforces the need for lifelong surveillance by echocardiography.

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