Coarctation of the aorta (CoA) is a relatively common defect that accounts for 5-8% of all congenital heart defects. 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). It imposes significant afterload on the left ventricle (LV), which results in increased wall stress and compensatory ventricular hypertrophy.
Treatment in patients with Aortic Coarctation includes the use of diuretics and inotropic drugs. Prostaglandin E1 (0.05-0.15 mcg/kg/min) is infused intravenously to open the ductus arteriosus. Ventilatory assistance is provided to patients with markedly increased work of breathing. Infusion of inotropic drugs (dopamine, dobutamine, epinephrine) is useful when ventricular dysfunction is present, especially with hypotension. A Foley catheter is inserted to monitor renal perfusion and urine output.
Coarctation of the aorta accounts for approximately 8% of all congenital heart defects in Japan. It is common for this defect to be noted in the first year of life due to the early onset of symptoms.This occurs in up to 50% of patients with coarctation and is thought to be a result of the increased pressure within the aortic segment proximal to the narrowed region forcing this vessel to remain open.