Fact-sheet: Coarctation of aorta
Updated on 09/17/2021 at 12:16 PM
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Definition
Stenotic malformation of the thoracic aorta, either isolated or occurring as part of a malformative syndrome
Clinical features
Blood pressure differential between upper and lower limbs, hypertension, heart failure
Radiography
Chest X-ray: - Distinctive appearance of the left border of the mediastinal silhouette at the level of the proximal descending aorta, forming a "3" sign, corresponding to post-stenotic dilation of the descending aorta, followed by the coarctation stenosis, while the upper segment corresponds either to the pre-stenotic proximal descending aorta or to dilation of the left subclavian artery. - Rib notching along the inferior border of the 3rd to 9th ribs caused by internal thoracic collateral circulation
Ultrasound
Prenatal diagnosis is possible in the congenital form: narrowing of the
aortic caliber with tubular hypoplasia. Asymmetry of the ventricular chambers with left ventricular hypoplasia.
MRI
Has replaced conventional arteriography.
Gadolinium-enhanced MR angiography.
Current reference examination for pre- and postoperative work-up
Classification
Coarctation syndrome combines:
- Coarctation of aorta
- Ventricular septal defect
- Tubular hypoplasia of the aortic arch
- and patent ductus arteriosus.
Differential diagnosis
- Pseudocoarctation (aortic kinking)
- Aortic hypoplasia