Aort coarctation

Yıl 2014, Cilt: 6 Sayı: 3, 1 - 5, 01.12.2014

Nilüfer Ekşi Duran Yetkin Korkmaz Feyza Ballı Kurt Serdar Mustafa Yılmazer Bekir Yılmaz Cingözbay

Öz

Coarctation of the aorta is a type of congenital heart disease. Aortic coarctation is a narrowing of the aorta most commonly found in the area where the ductus arteriosus its called ligamentum arteriosum after regression inserts 1 . The ductus arteriosus that is a blood vessel connecting between the pulmonary artery and the proximal descending aorta allows most of the blood from the right ventricle to dessending aorto due to non-functioning lungs in fetal life. Although the appropriate type of treatment for coarctation of the aorta remains somewhat controversial, surgical and endovasculer approach is performed successfully. Complication rate is very high untreated patients. These complications include stroke, early-onset coronary artery disease, and brain aneurysm and aortic rupture. However, several long-term follow-up studies have suggested that despite successful treatment , survival is shorter than expected due to postoperative hypertension and cardiovascular complications.This paper is mainly prepared as a review releated with adult aort coarctation.

Anahtar Kelimeler

aort coarctation, endovascular treatment

Aort koarktasyonu

Öz

Aort koarktasyonu kongenital bir kalp hastalığıdır. Çoğunlukla duktus arteryozusun geriledikten sonra ligamentum arteryosus adını alır aortaya tutunduğu bölgede gelişen segmental bir daralmayı tanımlamaktadır. Duktus arteryosus fetal yaşamda fonksiyone olmayan akciğer fizyolojisi nedeniyle sağ ventriküle gelen kanı pulmoner arterden inen aortaya ileterek normal dolaşımı sağlama görevini yürütmektedir. Aort koarktasyonunda uygun tedavi yaklaşımı tartışmalı olmakla birlikte; cerrahi ve endovasküler girişimler başarıyla uygulanmaktadır. Tedavi edilmemiş vakalarda komplikasyon oranları yüksektir. Bu komplikasyonlar stroke, premature koroner arter hastalığı, serebrovaskuler anevrizma ve aort rüptürüdür. Uzun dönem takipli çalışmalarda; hipertansiyon ve kardiyovaskuler komplikasyonlar nedeni ile başarılı tedaviye rağmen yaşamın beklenildiği gibi uzamadığı saptanmıştır. Bu yazı ağırlıklı olarak erişkin aort koarktasyonu ile ilişkin bir derleme olarak hazırlanmıştır.

Anahtar Kelimeler

aort koarktasyonu, endovasküler tedavi

Kaynakça

• 1. Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation 2008;118:e714-833.
• 2. Kenny D, Hijazi ZM. Coarctation ofthe aorta:fromfetallifetoadulthood.Cardiol J 2011;18:487-495.
• 3. Hiratzka LF, Bakris GL, Beckman JA,et al. 2010ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/ STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. Areport of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, AmericanAssociationforThoracicSurgery, AmericanCollegeofRadiology,AmericanStrokeAssociation, SocietyofCardiovascularAnesthesiol-ogists, Societyfor CardiovascularAngiography and Interventions, Society of Interventiona lRadiology ,Societyof Thoracic Surgeons ,and Society for Vascular Medicine .J Am Coll Cardiol 2010;55:e27-129.
• 4. Campbell M. Natural history of coarctation of the aorta. Br Heart J 1970;32: 633-640.
• 5. Duran AC, Frescura C, Sans-Coma V, et al. Bicuspid aortic valves in hearts with other congenital heart disease. J Heart Valve Dis. Nov 1995;4(6):581-590.
• 6. Mahimaiha J, Patra S, Subramaniun AP, et al. Coarctoplasty and Stenting in a Case of Ventricular Septal Defect With Eisenmenger’s Syndrome: A Clinical Dilemma. World J Pediatr Congenit Heart Surg. 2014;5(3):481-483.
• 7. Neema PK, Singha SK, Manikandan S, et al. Transesophageal echocardiography and intraoperative phlebotomy during surgical repair of coarctation of aorta in a patient with atrial septal defect, moderately severe mitral regurgitation and severe pulmonary hypertension. J Clin Monit Comput. 2012;26(3):217-221.
• 8. Sınha S.N, Kardatzke M.L, Cole R.B, et al.Coarctation of the Aorta in Infancy. Circulation, Volume XL, September 1969; 385-389.
• 9. Bonnet L. M. Sur la lesion dite stenose congenitale de l’aorte dans la region de l’isthme. Rev Med (Paris)1903; 23: 108.
• 10. Hamdan MA. Coarctation of the aorta: a comprehensive review. J Arab Neonatal Forum 2006; 3: 5-13.
• 11. Volkl TM, Degenhardt K, Koch A, et al. “Cardiovascular anomalies in children and young adults with Ullrich-Turner syndrome the Erlangen experience”. Clin Cardiol 2005; 28 (2): 88–92.
• 12. Marc Cohen, MD, Valentin Fuster, MD, Peter M. Steele, MBBS, et al. McGoon.Coarctation of the Aorta Long-term Follow-up and Prediction of Outcome After Surgical Correction. Circulation 1989;80: 840-845.
• 13. Crafoord C, Nylin G. Congenital coarctation of the aorta and its surgical treatment. J Thorac Surg 1945;14: 347.
• 14. Singer MI, Rowen M, Dorsey TJ. Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn. Am Heart J 1982;103:131-132.
• 15. O’Laughlin MP, Perry SB, Lock JE, et all. Use of endovascular stents in congenital heart disease. Circulation 1991;83: 1923-1939.
• 16. Reich O, Tax P, Bartakova H, et al. Long-term(up to 20 years) results of percutaneous balloon angioplasty of recurrent aortic coarctation without use of stents. Eur Heart J 2008;29: 2042-2048.
• 17. Walhout RJ, Lekkerkerker JC, Ernst SM, et al. Angioplasty for coarctation in different aged patients. Am Heart J 2002;144: 180-186.
• 18. Munayer CJ, Zabal CC, Ledesma VM, et al. Balloon angioplasty in aortic coarctation: a multicentric study in Mexico. Arch Cardiol Mex 2002;72: 20-28.
• 19. Yetman AT, Nykanen D, McCrindle BW, et al. Balloon angioplasty of recurrentcoarctation: a 12-year review. J Am Coll Cardiol 1997; 30: 811-816.
• 20. Fletcher SE, Nihill MR, Grifka RG, et al. Balloon angioplasty of native coarctation of the aorta: midterm follow-up and prognostic factors. J Am Coll Cardiol 1995;25: 730-734.
• 21. Tan JL, Mullen M. Emergency stent graft deployment for acute aortic rupture following primary stenting for aortic coarctation. Catheter Cardiovasc Interv 2005;65(2):306-309.
• 22. Hijazi ZM. Catheter intervention for adult aortic coarctation: be very careful! [comment]. Catheter Cardiovasc Interv 2003;59(4):536- 537.
• 23. Varma C, Benson LN, Butany J, et al. Aortic dissection after stent dilatation for coarctation of the aorta: a case report and literature review. Catheter Cardiovasc Interv 2003;59(4):528- 535.
• 24. Forbes TJ, Garekar S, Amin Z, et al. Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. Catheter Cardiovasc Interv 2007;70: 276-285.
• 25. Pedulla DM, Grifka RG, Mullins CE,et al. Endovascular stent implantation for severe recoarctation of the aorta: case report with angiographic and 18-month clinical follow-up. Cathet Cardiovasc Diagn 1997;40: 311-314.
• 26. Yazıcı HU, Göktekin Ö, Ulus T, et al. Erişkinlerde aort daralmasının stent ile tedavisine ilişkin ilk deneyimlerimiz.Kardiyol Dern Arş - Arch Turk Soc Cardiol 2011;39(3):214-218.
• 27. Chessa M, Carrozza M, Butera G, et al. Results and mid-long-term follow-up of stent implantation for native and recurrent coarctation of the aorta. Eur Heart J 2005;26: 2728-2732.
• 28. Holzer R, Qureshi S, Ghasemi A, et al. Stenting of aortic coarctation: acute, intermediate, and long-term results of a prospective multi-institutional registry-Congenital Cardiovascular Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv 2010;76: 553-563.
• 29. Hasan Basri Erdoğan, Hasan Ardal, Suat Nail Ömeroğlu, et al. Aort koarktasyonu cerrahi tedavisi: Yirmi yıllık deneyim. T ürk Göğüs Kalp Damar Cer Derg 2006;14(2):117-121.
• 30. Bouchart F, Dubar A, Tabley A, et al. Coarctation ofthe aorta in adults: Surgical results and long-term follow-up.Ann Thorac Surg 2000; 70: 1483-1488.
• 31. Knyshov GV, Sitar LL, Glagola MD, et al. Aortic aneurysms at the side of the repair of coarctation of the aorta: A review of 48 patients. Ann Thorac Surg 1996;61: 935-939.
• 32. Morgan L. Brown , Harold M. Burkhar, Heidi M. Connolly,,et al. Schaff Coarctation of the Aorta. Lifelong Surveillance is Mandatory Following Surgical Repair. J Am Coll Cardiol . 2013; 62: 1020-1025.
• 33. Backer CL, Mavroudis C. Coarctation of the aorta and interrupted aortic arch. In: Baue AE, editor. Glenn’s thoracic andcardiovascular sur gery. 6 th ed. Connecticut: Appleton & Lange; 1996. p. 1243-1269.
• 34. Fujita T, Fukushima N, Taketani S, et al. Late true aneurysm after bypass grafting forlong aortic coarctation. Ann Thorac Surg 1996; 62: 1511-1513.
• 35. Clarkson PM, Nicholson MR, Barratt-Boyes BG, et al. Results after repair of coarctation of the aortabeyond infancy: a 10 to 28 year follow-up with particular reference to late systemic hypertension. Am J Cardiol 1983;51: 1481-1488.
• 36. Correia AS, Alves AG, Paiva M, et al. Long-term follow-up after aortic coarctation repair:The unsolved issue of exercise-induced hypertension. Rev Port Cardiol. 2013;32:879-883
• 37. Cohen M, Fuster V, Steele PM, et al. Coarctation of the aorta. Long-term follow-up and prediction of outcome after surgical correction. Circulation. 1989;80(4):840-845.