ABSTRACT
Coarctation of the aorta (CoA) is usually a localized narrowing of the aortic isthmus with a shelf-like infolding of the posterior wall of the aorta, in most cases opposite to the origin of the ductus arteriosus or the ligamentum arteriosum. Although usually CoA is a localized narrowing, it may be accompanied by aortic arch hypoplasia and/or a prolonged tubular narrowing of the isthmus. Unoperated significant CoA is rare, and is usually associated with significant collateral circulation. In adulthood, untreated coarctation results in hypertension in the precoarctation region, hypotension in the postcoarctation region, in notable left ventricular myocardial hypertrophy, and in advanced cases even in left ventricular dilatation and systolic left ventricular dysfunction. In the presence of coarctation or recoarctation, properly controlled hypertension may result in inadequate blood pressure below the coarctation site, sometimes manifesting itself as lower limb pain. After successful treatment of CoA, pregnancy should be tolerated without major problems although hemodynamic.
