Coarctation of the Aorta

Coarctation of the aortaCoarctation of the aorta (CoA), aortic arch hypoplasiaAortic arch hypoplasia and interrupted aortic archInterrupted Aortic Arch are congenital lesions whereby the aortic arch is either atretic, discontinuous or small for body surface area. Coarctation of the aortaCoarctation of the aorta (CoA) can present in the neonate, infant, childChildren or rarely in the adult. The timing of presentation is dependent on the severity of the coarctation, the presence of a PDAPersistent ductus arteriosus (PDA), and any associated arch hypoplasia. In neonates with severe coarctation and duct dependant systemic circulationDuct dependant Circulation, early institution of PGEs is critical in initial management. For simple coarctation without significant proximal arch hypoplasia, an extended end to end anastomosis via a left thoracotomyThoracotomy is preferred with low rates of reintervention and low mortality. Associate transverse arch hypoplasia may require more extensive surgery. Older childrenChildren are increasingly managedSubclavian flap repair with interventional approaches including balloon dilatation and stenting.