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Coarctation of the aorta

Marco Astengo, Caroline Berntsson, Åse A Johnsson, Peter Eriksson, Mikael Dellborg
OBJECTIVE: Coarctation of the aorta (CoA) is a common condition. Adult patients with newly diagnosed CoA and patients with recurring or residual CoA require evaluation of the severity of aortic obstruction. Cardiac catheterization is considered the gold standard for the evaluation of hemodynamically significant CoA. The European Society of Cardiology (ESC) Guidelines for the management of grown-up congenital heart disease (GUCH) include noninvasive criteria for identifying significant CoA...
October 25, 2016: Congenital Heart Disease
Jan L Bruse, Abbas Khushnood, Kristin McLeod, Giovanni Biglino, Maxime Sermesant, Xavier Pennec, Andrew M Taylor, Tain-Yen Hsia, Silvia Schievano
OBJECTIVES: Even after successful aortic coarctation repair, there remains a significant incidence of late systemic hypertension and other morbidities. Independently of residual obstruction, aortic arch morphology alone may affect cardiac function and outcome. We sought to uncover the relationship of arch 3-dimensional shape features with functional data obtained from cardiac magnetic resonance scans. METHODS: Three-dimensional aortic arch shape models of 53 patients (mean age, 22...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Amy E Burchell, Jonathan C L Rodrigues, Max Charalambos, Laura E K Ratcliffe, Emma C Hart, Julian F R Paton, Andreas Baumbach, Nathan E Manghat, Angus K Nightingale
European guidelines recommend that patients with hypertension be assessed for asymptomatic organ damage and secondary causes. The authors propose that a single magnetic resonance imaging (MRI) scan can provide comprehensive first-line imaging of patients assessed via a specialist hypertension clinic. A total of 200 patients (56% male, aged 51±15 years, office BP 168±30/96±16 mm Hg) underwent MRI of the heart, kidneys, renal arteries, adrenals and aorta. Comparisons were made with other imaging modalities where available...
October 19, 2016: Journal of Clinical Hypertension
Sang-Chol Lee
Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension...
September 2016: Journal of Hypertension
Reyhan Dedeoglu, Levent Saltık, Sezen Ugan Atik, Ayşe Güler Eroglu
For a newborn, surgical correction has been the primary treatment of native coarctation at most centers; however, there has been an increased use of balloon angioplasty (BA). The anterograde transvenous (AT) technique is another alternative way for coarctation (AoC) angioplasty in low weight patients with large ventricular septal defect (VSD). Four, 5-day-old to 7-month-old, infants weighing 2500, 2700, 2800, and 3400g, respectively presented to emergency unit (EU) with cyanosis, tachypnea, and loss of weight...
September 2016: Indian Heart Journal
Jonathan P Mynard, Remi Kowalski, Michael M H Cheung, Joseph J Smolich
Wave reflection from the site of aortic coarctation produces a reflected backward compression wave (BCW) that raises left ventricular (LV) afterload. However, not all reflected wave power will propagate back to the LV. This study investigated the hypothesis that the BCW is partially transmitted into supra-aortic vessels as a forward wave and explored the consequences of this phenomenon for cerebral and LV haemodynamic load. In eight sheep, high fidelity pressure and flow were measured in the aortic trunk (AoT) and brachiocephalic trunk (BCT, the single supra-aortic vessel present in sheep) at baseline and during two levels of proximal descending aortic constriction...
October 11, 2016: Biomechanics and Modeling in Mechanobiology
Satyam Veean, Nancy Thakkar, Supriya Gupta, Jayanth Keshavamurthy
No abstract text is available yet for this article.
October 5, 2016: Postgraduate Medical Journal
L Palmeri, G Gradwohl, M Nitzan, E Hoffman, Y Adar, Y Shapir, R Koppel
OBJECTIVE: Fetal echocardiography, physical examination and pulse oximetry detect only half of coarctation of aorta (CoA) cases. We aimed to quantify delayed arrival and diminished amplitude of lower extremity photoplethysmographic (PPG) pulses relative to the right hand in affected patients. STUDY DESIGN: We studied 8 CoA infants and 32 healthy controls. The pulse arrival time difference between foot and hand (f-hTD) and pulse amplitude ratio (F/H) were measured on PPG signal waveforms by digitally-determining maxima and minima of systolic decrease of light transmission...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
N L P Starmans, G J Krings, M M C Molenschot, F van der Stelt, J M P J Breur
BACKGROUND: Children with aortic coarctations (CoA) are increasingly percutaneously treated. Good visualisation of the CoA is mandatory and can be obtained with three-dimensional rotational angiography (3DRA). This study aims to compare the diagnostic and therapeutic additional value of 3DRA with conventional biplane angiography (CA) in children with a CoA. METHODS: Patients undergoing percutaneous treatment of CoA with balloon angioplasty (BA) or stent between 2003 and 2015, were retrospectively reviewed on success rate, complications, radiation and technical settings...
November 2016: Netherlands Heart Journal
Zahra Keshavarz-Motamed, Farhad Rikhtegar Nezami, Ramon A Partida, Kenta Nakamura, Pedro Vinícius Staziaki, Eyal Ben-Assa, Brian Ghoshhajra, Ami B Bhatt, Elazer R Edelman
OBJECTIVES: This study sought to investigate the impact of transcatheter intervention on left ventricular function and aortic hemodynamics in patients with mild coarctation of the aorta (COA). BACKGROUND: The optimal method and timing of transcatheter intervention for COA remains unclear, especially when the severity of COA is mild (peak-to-peak transcoarctation pressure gradient <20 mm Hg). Debate rages regarding the risk/benefit ratio of intervention versus long-term effects of persistent minimal gradient in this heterogeneous population with differing blood pressures, ventricular function, and peripheral perfusion...
September 26, 2016: JACC. Cardiovascular Interventions
Sang-Chol Lee
Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension...
September 2016: Journal of Hypertension
Ahmed Kheiwa, Sanjeev Aggarwal, Thomas J Forbes, Daniel R Turner, Daisuke Kobayashi
Myocardial deformation measured by speckle tracking echocardiography can detect subtle abnormalities of left ventricular function before an obvious abnormality in traditional echocardiographic parameters such as ejection fraction is seen. We hypothesized that patients with coarctation of the aorta (CoA) may have impaired myocardial deformation that may persist even after successful transcatheter intervention. This is a retrospective study to assess the myocardial deformation in patients undergoing transcatheter intervention of CoA...
September 8, 2016: Pediatric Cardiology
Sanitra Anuwutnavin, Gary Satou, Ruey-Kang Chang, Greggory R DeVore, Ashley Abuel, Mark Sklansky
OBJECTIVES: To identify practical prenatal sonographic markers for the postnatal diagnosis of coarctation of the aorta. METHODS: We reviewed the fetal echocardiograms and postnatal outcomes of fetal cases of suspected coarctation of the aorta seen at a single institution between 2010 and 2014. True- and false-positive cases were compared. Logistic regression analysis was used to determine echocardiographic predictors of coarctation of the aorta. Optimal cutoffs for these markers and a multivariable threshold scoring system were derived to discriminate fetuses with coarctation of the aorta from those without coarctation of the aorta...
September 14, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Allard T van den Hoven, Anthonie L Duijnhouwer, Andreas Eicken, Jamil Aboulhosn, Christiaan de Bruin, Philippe F Backeljauw, Laurent Demulier, Massimo Chessa, Anselm Uebing, Gruschen R Veldtman, Aimee K Armstrong, Annemien E van den Bosch, Maarten Witsenburg, Jolien W Roos-Hesselink
OBJECTIVES: This study examines the outcome and procedural outcomes of percutaneous stent angioplasty for aortic coarctation in patients with Turner syndrome (TS). BACKGROUND: TS occurs in 1 in 2,500 live-born females and is associated with aortic coarctation. METHODS: In this multicenter, retrospective cohort study, all patients with TS and a coarctation of the aorta, treated with percutaneous stent implantation were included. The procedural strategies were dictated by local protocols...
September 15, 2016: Catheterization and Cardiovascular Interventions
Roland Fiszer, Małgorzata Szkutnik, Linda Litwin, Sebastian Smerdziński, Beata Chodór, Jacek Białkowski
INTRODUCTION: Balloon angioplasty (BAP) and aortic or pulmonary balloon valvuloplasty (BAV, BPV) are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice. AIM: To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland) launched and developed. These catheters have not been clinically evaluated yet...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Inga Voges, Julian Kees, Michael Jerosch-Herold, Hannes Gottschalk, Jens Trentmann, Christopher Hart, Dominik D Gabbert, Eileen Pardun, Minh Pham, Ana C Andrade, Philip Wegner, Ines Kristo, Olav Jansen, Hans-Heiner Kramer, Carsten Rickers
BACKGROUND: The increased cardiovascular morbidity of adults with late repair of aortic coarctation (CoA) has been well documented. In contrast, successful CoA repair in early childhood has a generally good prognosis, though adverse vascular and ventricular characteristics may be abnormal, which could increase long-term risk. This study sought to perform a comprehensive analysis of aortic elasticity and left ventricular (LV) function in patients with aortic coarctation (CoA) using cardiovascular magnetic resonance (CMR)...
2016: Journal of Cardiovascular Magnetic Resonance
Brian Raffetto, Neil Rifenbark, Ashokkumar Jain
BACKGROUND: Traumatic axilloaxillary arteriovenous (AV) fistulas are rare occurrences, with the predominance of AV fistulas in this region occurring as an alternative surgical intervention in patients who are undergoing hemodialysis. CASE REPORT: We describe the case of a young man with this condition caused by a previous penetrating trauma who had a delayed diagnosis primarily because of the infrequency of the clinical presentation. This is one of a few documented cases of axilloaxillary AV fistulas in the setting of trauma...
September 6, 2016: Journal of Emergency Medicine
Nicola Maschietto, Luca Semplicini, Giulio Ceolotto, Arianna Cattelan, Helen Poser Dvm, Ilaria Iacopetti, Gabriele Gerardi, Giulia Maria De Benedictis, Tommaso Pilla, Daniele Bernardini, Luca Aresu, Stefania Rizzo, Cristina Basso, Andrea Semplicini, Ornella Milanesi
BACKGROUND: Stent implantation is the treatment of choice for adolescents and adults with aortic coarctation (CoAo). Despite excellent short-term results, 20%-40% of the patients develop arterial hypertension later in life, which was attributed to inappropriate response of the aortic baroreceptors to increased stiffness of the ascending aorta (ASAO), either congenital or induced by CoAo repair. In particular, it has been hypothesized that stent itself may cause or sustain hypertension...
September 7, 2016: Congenital Heart Disease
Peng Huang, Jinwen Luo, Jian Liu, Xiaohui Yang, Xiaoming Peng, Pingbo Liu
OBJECTIVE: To evaluate the safety of surgical repair for neonatal aortic coarctation combined with ventricular septal defect.
 METHODS: Twenty-three aortic coarctation neonates received surgical treatment and their clinical data between April, 2013 and May, 2015 were analyzed retrospectively. All patients underwent coarctation repair + ventricular septal defect repair and mild hyperthermia cardiopulmonary bypass under the condition of general anesthesia. All patients were subjected to delayed sternal closure...
July 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Linqi Yang, Xiuzhen Chua, Dimple D Rajgor, Bee Choo Tai, Swee Chye Quek
BACKGROUND/OBJECTIVES: The treatment of native coarctation of aorta (CoA) has evolved since surgery performed in 1944, followed by transcatheter balloon angioplasty and recently, widely adopted stent implantation. Despite good results demonstrated with stent implantation, a systematic review and meta-analysis (SRMA) looking at the efficacy and safety of the intervention, particularly in younger population is yet to be done. We aimed to obtain pooled estimates of the success and complication rates after transcatheter stent implantation in the treatment of native CoA based on SRMA...
November 15, 2016: International Journal of Cardiology
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