Anomalies of the Aortic Arch, Aortic Coarctation, Interrupted Aortic Arch, and Vascular Rings

Abstract

Coarctation of the Aorta (CoA) or Aortic Coarctation is one of the most common types of congenital heart disease with a prevalence of 1 in 2500 births, consisting of 5–8% of all congenital heart defects. Some cardiovascular abnormalities are associated with CoA. Anesthesia for coarctation of the aorta mandates an appropriate understanding of the pathology and embryology of the disease. Two different mechanisms have been proposed: The “hemodynamic theory or flow theory” and the “ductal theory or ductus tissue theory.” The clinical features include a wide range pending on the age of disease presentation: The prenatal (fetal), the neonatal, infancy, childhood and adolescence, and adult periods. The main treatment approaches include surgical correction, balloon angioplasty (or balloon dilatation), and stent dilatation. Preoperative, intraoperative, and postoperative periods mandate sophisticated anesthesia care. Other pathologies of the aorta and aortic arch including Williams Syndrome, Kommerell’s diverticulum, and the Interrupted Aortic Arch are among the other pathologies discussed in this chapter.