Bruins C
Eur J Cardiol. 1978 Aug;8(1):87-97.
The family of juxtaductal coarctation includes pseudocoarctation, local stenosis and hypoplasia, atresia or interruption of aortic arch or isthmus. The cause is usually VSD with LV outflow obstruction. Abnormal length of the preductal aorta is characteristic. VSD closure makes infantile hypoplasia evolve into adult stenosis, sometimes before birth. Normal subclavian 'migration' is interrupted in 2 out of 3 cases. So-called typical coarctation is either stenosis of the isthmic orifice or the isthmus in toto. Ductus wall tissue radiates too far into the descending aortic wall. Juxtaductal coarctation is displaced from a pre- into a postductal position by flow and secondary tissue formation. A straddling ductus does not straddle the stenosis but a circular fold in the descending aortic wall, caused by ductus tissue. Patent ductus arteriosus is too frequent a complication, prolonged as well as persistent. Ductus closure causes loss of femoral pulse pressure in different ways. Infantile hypoplasia is treated by promoting its development into adult stenosis, then resection.
导管周围缩窄包括假性缩窄、局部狭窄和发育不全、主动脉弓或峡部闭锁或中断。病因通常是室间隔缺损伴左心室流出道梗阻。动脉导管前主动脉长度异常是其特征。室间隔缺损闭合会使婴儿型发育不全发展为成人型狭窄，有时在出生前就会发生。三分之二的病例中正常锁骨下动脉“移位”被中断。所谓典型缩窄是峡部开口或整个峡部的狭窄。动脉导管壁组织过度延伸至降主动脉壁。导管周围缩窄因血流和继发性组织形成而从动脉导管前移位至动脉导管后位置。横跨的动脉导管并非横跨狭窄部位，而是横跨由动脉导管组织引起的降主动脉壁的环形褶皱。动脉导管未闭是一种非常常见的并发症，包括持续性和慢性的。动脉导管闭合以不同方式导致股动脉脉压消失。婴儿型发育不全的治疗方法是促使其发展为成人型狭窄，然后进行切除。
