Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Usually caused by a congenital indentation in the posterior wall of the aorta that usually is distal to the origin of the left subclavian artery at the level of the ductus arteriosus. Infantile type coarctation causes a diffuse narrowing while adult type coarctation causes a focal narrowing.
The collatateral circulation is via the internal mammary arteries, the costocervical trunk, and the intercostal arteries.
Seventy-five percent of patients have a bicuspid aortic valve, and ASD / VSD / PDA / mitral valve deformities can also be seen.
The adult type often has intercostal rib notching due to collateral flow through dilated pulsatile intercostal arteries and it is seen in 75% of older children with coarctation. It is unusual to see rib notching before 6 years of age. It is seen in the 3rd - 9th ribs because the 1st and 2nd ribs intercostal arteries come from the thyocervical trunk which is above the coarctation. Irregular wavy densities seen on the lateral film reflect dilation of the internal mammary arteries.
Another sign in the adult type is the "3" sign which is created by a prominent left subclavian artery, the coarctation and post stenotic dilation of the descending aorta. The barium swallow shows a reversed "3" which represents the aortic impression on the esophagus above and below the coarctation.
See References Chapter.
Section Top | Title Page
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2013 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
This site complies with the HONcode standard for trustworthy health information: