Aortic coarctation angiography

Cardiac catheterization and angiography are not necessary for making a diagnosis of coarctation of aorta. They are used in cases with inconsistent diagnosis with echocardiography. These procedures are a pre-requisite if angioplasty is planned. It is used to determine the severity, anatomy, associated cardiac defects, pressure gradient across the aorta.

Though cardiac catheterization is not necessary to diagnose coarctation of aorta, they are useful in certain situations:

• Helps to evaluate anatomy (diffuse, long segment, pseudocoarctation) and severity of lesion in the aorta.
• Helps to diagnosis other associated cardiac defects.
• Helps to evaluate the degree and presence of hypoplasia of the aortic arch.
• Helps in diagnosis of coarctation in cases when echocardiography fails to give a consistent results.
• It is necessary to perform catheterization in cases when angioplasty and stent placement are planned.
• Helps to find the pressure gradient across the coarctated segment. A pressure gradient of more than 20mm Hg usually signifies severe lesion. The pressure gradient depends on the severity of constriction, presence of collateral (size and number), associated lesions (patent ductus arteriosus).

• Useful to diagnosis other associated cardiac defects like ventricular septal defect.

• In cases of suspected neurofibromatosis.
• If coarctation of aorta is suspected clinically but thoracic angiography fails to show any thoracic coarctation.

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