Isolated Coarctation of the Aorta: Current Concepts and Perspectives
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 e...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.817866/full |
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| author | Ami B. Bhatt Maria R. Lantin-Hermoso Curt J. Daniels Robert Jaquiss Benjamin John Landis Bradley S. Marino Rahul H. Rathod Robert N. Vincent Bradley B. Keller Juan Villafane |
| author_facet | Ami B. Bhatt Maria R. Lantin-Hermoso Curt J. Daniels Robert Jaquiss Benjamin John Landis Bradley S. Marino Rahul H. Rathod Robert N. Vincent Bradley B. Keller Juan Villafane |
| author_sort | Ami B. Bhatt |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T17:42:43Z |
| format | Article |
| id | doaj.art-d11f95be2a034a8b900cd4b280b2f7ff |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T17:42:43Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d11f95be2a034a8b900cd4b280b2f7ff2022-12-22T03:22:45ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.817866817866Isolated Coarctation of the Aorta: Current Concepts and PerspectivesAmi B. Bhatt0Maria R. Lantin-Hermoso1Curt J. Daniels2Robert Jaquiss3Benjamin John Landis4Bradley S. Marino5Rahul H. Rathod6Robert N. Vincent7Bradley B. Keller8Juan Villafane9Departments of Internal Medicine and Pediatrics and Division of Cardiology, Harvard Medical School, Boston, MA, United StatesSection of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United StatesDepartments of Pediatrics and Internal Medicine, The Ohio State University Medical Center, Columbus, OH, United StatesDepartment of Cardiovascular and Thoracic Surgery and Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United StatesDepartment of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, United StatesDepartment of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, OH, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, New York Medical College, Valhalla, NY, United StatesCincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United StatesCincinnati Children's Heart Institute and the Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United StatesCurrent 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.https://www.frontiersin.org/articles/10.3389/fcvm.2022.817866/fullcoarctation of the aortacongenital heart diseasecatheter interventionheart surgeryadult congenital heart disease |
| spellingShingle | Ami B. Bhatt Maria R. Lantin-Hermoso Curt J. Daniels Robert Jaquiss Benjamin John Landis Bradley S. Marino Rahul H. Rathod Robert N. Vincent Bradley B. Keller Juan Villafane Isolated Coarctation of the Aorta: Current Concepts and Perspectives Frontiers in Cardiovascular Medicine coarctation of the aorta congenital heart disease catheter intervention heart surgery adult congenital heart disease |
| title | Isolated Coarctation of the Aorta: Current Concepts and Perspectives |
| title_full | Isolated Coarctation of the Aorta: Current Concepts and Perspectives |
| title_fullStr | Isolated Coarctation of the Aorta: Current Concepts and Perspectives |
| title_full_unstemmed | Isolated Coarctation of the Aorta: Current Concepts and Perspectives |
| title_short | Isolated Coarctation of the Aorta: Current Concepts and Perspectives |
| title_sort | isolated coarctation of the aorta current concepts and perspectives |
| topic | coarctation of the aorta congenital heart disease catheter intervention heart surgery adult congenital heart disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.817866/full |
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