Coarctation of the aorta

Coarctation of the aorta is a common form of congenital heart disease. Presentation, evaluation, and treatment of coarctation of the aorta is different in neonates and infants compared with older children. Neonates may present in shock and require prostaglandin E₁ to maintain ductal patentcy until the time of surgical repair. Older children usually present with upper extremity hypertension or murmur. The approach to surgical repair of coarctation in neonates and infants depends on the presence or absence of concomitant defects and the degree of associated arch hypoplasia. For older children, robust collaterals and limited mobility of the aorta may mandate patch repair, interposition graft, or bypass of the coarctation segment. Percutaneous techniques, including angioplasty and stent placement, are often viable options for older children and adolescents with native or recurrent coarctation. Surgical and interventional outcomes have improved over time. Reliable repair may be anticipated with a very low rate of morbidity and mortality, although lifetime follow-up is recommended.