Aortic coarctation classification




 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S.[mailto:psingh@perfuse.org], ; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S.[mailto:kfeeney@perfuse.org]

Overview
An aortic coarctation can be classified in three ways depending on the anatomical configuration. These include: preductal coarctation, ductal coarctation, and postductal coarctation. All classifications involve narrowings of the aorta that directly impact the aortic hemodynamics.

Classification
There are three types:
 * 1) Preductal coarctation: The narrowing is proximal to the ductus arteriosus. If severe, blood flow to the aorta distal (to lower body) to the narrowing is dependent on a patent ductus arteriosus, and hence its closure can be life-threatening. Preductal coarctation results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, leading to hypoplastic development of the aorta.
 * 2) Ductal coarctation: The narrowing occurs at the insertion of the ductus arteriosus. This kind usually appears when the ductus arteriosus closes.
 * 3) Postductal coarctation: The narrowing is distal to the insertion of the ductus arteriosus. Even with an open ductus arteriosus blood flow to the lower body can be impaired. Newborns with this  type of coarctation may be critically sick from the birth. This type is most common in adults. It is associated with notching of the ribs, hypertension in the upper extremities, and weak pulses in the lower extremities. Postductal coarctation is most likely the result of muscular ductal (ductus arteriosis) extends into the aorta during fetal life.