coarctation of the aorta

Question 1

what is coarctation of the aorta

Answer 1

narrowing of a segment

• usually on a descending part of the arch
• where the ductus enters the aorta
  
  • delayed duct closure can delay recognition of coarctation of the aorta

Question 2

clinical presentation of coarctation of the aorta

Answer 2

• weak/absent femoral pulses
• radio-femoral delay (only in chronic coarctation)
• systolic murmur loudest on the back
• sudden deterioration and collapse

Question 3

delayed duct closure and aortic coarctation

Answer 3

• often duct closure is delayed in these children
• blood flows through narrowed aorta → ductus arteriosus → pulmonary trunk
• reduced workload of LV

Question 4

what happens when the duct closes in aortic coarctation

Answer 4

• no bypass of the blood
• LV has to pump hard against the severe obstruction of the coarctation
• decreased CO and acute dilation of LV
  
  • sudden deterioration and collapse

Question 5

management of aortic coarctation

Answer 5

• re-open PDA w/ prostaglandin E1 or E2
• resection w/ end-to-end anastomosis
• subclavian patch repair
• balloon aortoplasty