TY - JOUR
T1 - Isolated Coarctation of the Aorta
T2 - Current Concepts and Perspectives
AU - Bhatt, Ami B.
AU - Lantin-Hermoso, Maria R.
AU - Daniels, Curt J.
AU - Jaquiss, Robert
AU - Landis, Benjamin John
AU - Marino, Bradley S.
AU - Rathod, Rahul H.
AU - Vincent, Robert N.
AU - Keller, Bradley B.
AU - Villafane, Juan
N1 - Publisher Copyright:
Copyright © 2022 Bhatt, Lantin-Hermoso, Daniels, Jaquiss, Landis, Marino, Rathod, Vincent, Keller and Villafane.
PY - 2022/5/25
Y1 - 2022/5/25
N2 - Current management of isolated CoA, localized narrowing of the aortic arch in the absence of other congenital heart disease, is a success story with improved prenatal diagnosis, high survival and improved understanding of long-term complication. Isolated CoA has heterogenous presentations, complex etiologic mechanisms, and progressive pathophysiologic changes that influence outcome. End-to-end or extended end-to-end anastomosis are the favored surgical approaches for isolated CoA in infants and transcatheter intervention is favored for children and adults. Primary stent placement is the procedure of choice in larger children and adults. Most adults with treated isolated CoA thrive, have normal daily activities, and undergo successful childbirth. Fetal echocardiography is the cornerstone of prenatal counseling and genetic testing is recommended. Advanced 3D imaging identifies aortic complications and myocardial dysfunction and guides individualized therapies including re-intervention. Adult CHD program enrollment is recommended. Longer follow-up data are needed to determine the frequency and severity of aneurysm formation, myocardial dysfunction, and whether childhood lifestyle modifications reduce late-onset complications.
AB - Current management of isolated CoA, localized narrowing of the aortic arch in the absence of other congenital heart disease, is a success story with improved prenatal diagnosis, high survival and improved understanding of long-term complication. Isolated CoA has heterogenous presentations, complex etiologic mechanisms, and progressive pathophysiologic changes that influence outcome. End-to-end or extended end-to-end anastomosis are the favored surgical approaches for isolated CoA in infants and transcatheter intervention is favored for children and adults. Primary stent placement is the procedure of choice in larger children and adults. Most adults with treated isolated CoA thrive, have normal daily activities, and undergo successful childbirth. Fetal echocardiography is the cornerstone of prenatal counseling and genetic testing is recommended. Advanced 3D imaging identifies aortic complications and myocardial dysfunction and guides individualized therapies including re-intervention. Adult CHD program enrollment is recommended. Longer follow-up data are needed to determine the frequency and severity of aneurysm formation, myocardial dysfunction, and whether childhood lifestyle modifications reduce late-onset complications.
KW - adult congenital heart disease
KW - catheter intervention
KW - coarctation of the aorta
KW - congenital heart disease
KW - heart surgery
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U2 - 10.3389/fcvm.2022.817866
DO - 10.3389/fcvm.2022.817866
M3 - Review article
C2 - 35694677
AN - SCOPUS:85138558855
SN - 2297-055X
VL - 9
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 817866
ER -