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Coarctation of Aorta, Pediatric

Luz Natal-Hernandez, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Discrete stenosis of the upper thoracic aorta, usually just opposite the site of insertion of the ductus arteriosus (juxtaductal). A segment of tubular hypoplasia and/or a remnant of...

DIAGNOSIS

HISTORY

There are two typical patterns for the clinical presentation of coarctation: 
  • An infant with CHF or shock: typically precipitated by ductal closure

    • Respiratory distress (dyspnea/tachypn...

TREATMENT

GENERAL MEASURES

  • For the sick neonate who presents with severe CHF or shock (ductal-dependent systemic blood flow):

    • Alprostadil (PGE1) prostaglandin infusion: 0.05 to 0.1 mcg/kg/min (anticipat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Reexamine every 12 months with four-extremity pulse and BP assessment.

  • Residual or recurrent coarctation

    • Occurs most commonly in those patients re...

ADDITIONAL READING

  • Carr JA. The results of catheter-based therapy compared with surgical repair of adult aortic coarctation. J Am Coll Cardiol.  2006;47(6):1101–1107. [View Abstract on OvidInsigh...

CODES

ICD9

747.10 Coarctation of aorta (preductal) (postductal) 

ICD10

Q25.1 Coarctation of aorta 

SNOMED

  • 7305005 Coarctation of aorta (disorder)

  • 253675002 Juxtaductal aortic coarctation (disorder)

  • 253679008...

FAQ

  • Q: When is the most appropriate time to perform surgical repair of simple coarctation?

  • A: Recommendations vary regarding the age at which asymptomatic children (without severe upper extremity hyper...

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