**4.3.1 Symptoms**

12 Congenital Heart Disease – Selected Aspects

balloon diameter size 80% to 100% of the size of the aortic valve annulus is chosen for valvuloplasty (Rao 1990). Immediate, short-term and long-term results following balloon aortic valvuloplasty (Figure 6) are encouraging. Only limited long-term results are available

Fig. 6. Bar graph showing maximum peak instantaneous Doppler gradients, indicative of

valvuloplasty and at intermediate-term (ITFU) and late (LTFU) follow-up. Note significant reduction (p 0.001) after valvuloplasty, which continues to be lower (p 0.001) at ITFU

For milder forms of AS, subacute bacterial endocarditis prophylaxis and periodic follow-up are necessary. Restriction from participation in competitive sports is recommended for all

The prevalence of coarctation of the aorta (CoA) was found to vary between 5% and 8% of CHDs; however, coarctation may be found more frequently in infants presenting with symptoms prior to one year of age. In the past, CoA was designated as preductal (or infantile) or postductal (or adult) type, depending on whether the coarctation segment was proximal or distal to the ductus arteriosus, respectively. However, a closer examination of the anatomy suggests that all coarctations are juxtaductal. The coarctation may be discrete, or a long segment of the aorta may be narrowed; the former is more common. Classic CoA is located in the thoracic aorta distal to the origin of the left subclavian artery, at about the level of the ductal structure. However, rarely, a coarcted segment may be present in the abdominal aorta. Varying degrees of hypoplasia of the isthmus of the aorta (the portion of the aorta between the origin of the left subclavian artery and the ductus arteriosus) and transverse aortic arch (the arch between the origin of the innominate artery and the left

severity of aortic stenosis, prior to (Pre), one day following (Post) balloon aortic

to-date (Galal et al 1997, Rao 1999).

and LTFU.

but mildest form of AS.

**4.3 Coarctation of the aorta** 

Children beyond infancy usually are asymptomatic; an occasional child will complain of pain or weakness in the legs. Most often, the coarctation is detected because of a murmur or hypertension which is detected on a routine examination (Rao 1995).
