Aortic Coarctation

Coarctation of the aorta is typically a discrete narrowing of the thoracic aorta just distal to the left subclavian artery. However, the constriction may be proximal to the left subclavian artery or rarely in the abdominal aorta.
Aortic coarctation presenting during adult life, most frequently represents cases of recoarctation, following previous transcatheter or surgical therapy, or missed cases of native coarctation. Aortic coarctation may be recognized in the adult, usually because of systemic arterial hypertension and discrepant upper and lower extremity pulses. Patient may complain of exertional headaches, leg fatigue or claudication.

Adult coarctation of aorta is quite rare because of reduced life expectancy. Without correction the mean life expectancy of patients with aortic
Problems with these techniques have included a significant incidence of aneurysm formation with Dacron patch aortoplasty, and an unacceptably high recoarctation rate with the subclavian flap aortoplasty. The technique of extended end–to–end anastomosis appears to give good short–term to intermediate–term results with a low complication rate and has gained in popularity as the technique of choice when possible to use5. A complication associated with all the surgical techniques is aortic dissection, which can occur even late after surgical repair. Surgical mortality is rare (usually less than 1 percent). Morbidity includes early postoperative paradoxical hypertension, left recurrent laryngeal nerve paralysis, phrenic nerve injury, and subclavian steal. Paraplegia due to spinal cord ischemia and mesenteric arteritis with bowel infarction are rare