The classic coarctation of the aorta is located in the thoracic aorta distal to the origin of the left subclavian artery at about the level of the ductal structure. The coarctation may be discrete, or a long segment of the aorta may be narrowed the former is more common. The localized constriction may form a shelflike structure with an eccentric opening or may be a membranous curtainlike structure with a central or eccentric opening. Pathologic anatomyĬoarctation of the aorta may be defined as a constricted aortic segment that comprises localized medial thickening, with some infolding of the medial and superimposed neointimal tissue. This article discusses the pathology, pathophysiology, clinical features, noninvasive and invasive evaluation, and therapy in patients with coarctation of the aorta. The diagnosis of coarctation of the aorta may be missed unless an index of suspicion is maintained, and diagnosis is often delayed until the patient develops congestive heart failure (CHF), which is common in infants, or hypertension, which is common in older children. Coarctation of the aorta may occur as an isolated defect or in association with various other lesions, most commonly bicuspid aortic valve and ventricular septal defect (VSD). Coarctation of the aorta (CoA) is a relatively common defect that accounts for 5-8% of all congenital heart defects.
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