主动脉收缩(CoA)
这是什么??
在这种情况下 主动脉 (将血液从心脏输送到身体的大动脉)变窄或收缩.
这种变窄影响血液流动，在这里动脉分支将血液沿着分开的血管输送到身体的上部和下部. CoA can cause high blood pressure or heart damage.
More information for parents of children with CoA
原因是什么??
在大多数儿童中，病因不明. Some children can have other heart defects along with coarctation.
它是如何影响心脏的?
Coarctation obstructs blood flow from the heart to the lower part of the body. Blood pressure increases above the constriction. 左心室的血压比正常情况要高得多，心脏必须更加努力地将血液泵过收缩的主动脉. This can cause thickening (hypertrophy) and damage to the overworked heart muscle.
How does the coarctation affect my child?
通常在出生时没有任何症状，但早在出生后的第一周就会出现. A baby may develop congestive heart failure or high blood pressure.
如果梗阻是轻微的，心脏不会过度劳累，也不会出现症状. 在一些儿童和青少年中，只有在发现高血压后才会发现缩窄.
对于缩窄可以做些什么?
The coarctation obstruction can be relieved using surgery or catheterization.
Surgery is often used to repair coarctation. A surgeon doesn’t have to open the heart to repair the defect. 有几种方法可以解决这个问题. One way is for the surgeon to remove the narrowed segment of the 主动脉. 另一种选择是在狭窄的部分缝合一个补丁，使用部分血管到手臂或人工合成材料的移植物.
Cardiac catheter balloon dilation and stent placement is also used, 更常见于老年患者和术后复发性缩窄患者. 在这种情况下，球囊可以拉伸狭窄的区域，而支架提供坚硬的支撑，以防止血管恢复到更小的尺寸.
有严重心绞痛的婴儿应该进行手术以解除梗阻. This may relieve heart failure in infancy and prevent problems later, such as developing high blood pressure as an adult because of the coarctation.
我的孩子会做什么活动?
如果缩窄已经修复, there is no important leftover obstruction or high blood pressure, your child may not need any special precautions regarding physical activity, and may be able to participate in normal activities without increased risk.
一些有梗阻的孩子, 高血压, 心肌异常或其他心脏缺陷可能会限制他们的身体活动. Check with your child's pediatric cardiologist about this.
我的孩子将来需要什么?
术后前景良好, but long-term follow-up by a pediatric cardiologist is needed. Rarely, coarctation of the 主动脉 may recur. Then another procedure to relieve the obstruction may be needed. 此外，即使主动脉狭窄已经修复，血压也可能保持在高位.
如何预防心内膜炎呢?
Children with coarctation of the 主动脉 may risk developing endocarditis. 您孩子的心脏病专家可能会建议您的孩子在缩窄修复后的一段线上电子游戏飞禽走兽内接受某些牙科手术前的抗生素治疗. 请参阅 心内膜炎 了解更多信息.
更多关于CoA成人的信息
主动脉缩窄是指主动脉在上体分支和下体分支之间变窄. It's typically in an isolated location just after the "arch" of the 主动脉. 堵塞会增加你手臂和头部的血压，但会降低你腿部的血压. Abnormalities of the aortic valve (usually bicuspid; see 主动脉狭窄和不全 节)也可能在场. 有时, 主动脉狭窄非常严重，以至于主动脉的上下部分之间基本上没有连接(“主动脉弓中断”).
原因是什么??
The area where coarctation of the 主动脉 occurs is usually in the same spot where the 开放性动脉导管 关闭. 有时, during normal closure of the ductus in the first week of life, tissue can build up and cause a narrowing.
心肌收缩是如何影响心脏的?
Coarctation of the 主动脉 can cause high blood pressure in the heart. 这会导致心脏主泵腔(左心室)的肌肉变厚. 最终，如果病情得不到治疗，心肌的功能可能会恶化.
缩窄对我有什么影响?
Many people don't know there's a problem. High blood pressure in the arms is typical. When present in a young person, it should prompt investigation for coarctation. 有时成年人也会头痛, 肾脏问题，经常流产, or lack of energy when using their legs. 然而，这些症状在普通人群中很常见，通常是由其他原因引起的.
If my coarctation was repaired in childhood, what can I expect?
Most patients repaired before 1985 underwent surgery. 根据缩窄的长度和位置等情况，外科医生有几种选择. 年轻的成年人可能在导管实验室进行了修复(称为 interventional or therapeutic catheterization)，通过在你腿上的一个小洞插入一个气球来扩大狭窄. Often a metal stent was left in place to hold the area open. This may also be an option if further narrowing occurs in an adult.
如果缩窄仍然存在怎么办? 成年后应该修复吗?
是的, 缩窄在任何年龄都可以修复，一旦诊断出来就应该尽快处理，这取决于缩窄的严重程度. 青少年和成人的缩窄通常可以通过心导管插入术治疗.
你可能遇到的问题
High blood pressure is the most common problem adults have. It can be present even if your coarctation was successfully fixed. 如果在5岁以后进行缩窄修复，则高血压更为常见. 儿童时期接受治疗的患者有再次发生缩窄(再缩窄)的风险，可能需要导尿. 大多数初次修复后主动脉再狭窄的患者通常没有症状, which makes regular assessment by a physician all the more important. Many times the area will renarrow to a degree, or other portions of the 主动脉 may enlarge (aneurysms) with potential to rupture. These may need to be addressed with further intervention. 患者可能会患上冠状动脉疾病，使他们容易心脏病发作. There may even be an increased risk of having an aneurysmal blood vessel in the head.
持续的关心
我将来需要什么?
每个已知主动脉缩窄的人都应该每年去看一次心脏病专家，他们在照顾患有先天性心脏病的成年人方面有专业知识，即使缩窄已经成功修复. Blood pressure should be measured in the arms and legs. 通常建议服用药物, typically beta blockers (atenolol or metoprolol) to control the blood pressure. Regular imaging of the 主动脉 should be done by echocardiography or MRI. CT scanning can also show the area well, but isn't advised for repeated routine checks because it involves radiation. 如果你正在接受任何类型的非心脏手术或侵入性手术，你也应该咨询一位在照顾患有先天性心脏病的成年人方面有专业知识的心脏病专家.
活动
Most activities are likely safe, and encouraged. 大强度等长运动, 比如力量举重, 可能是一个特别值得关注的问题特别是对于那些主动脉扩张的患者因为它会使血压迅速升高. 请参阅 身体活动及运动 了解更多信息.
心内膜炎的预防
Although infection of a coarctation can occur, it isn't likely. More commonly, patients may develop infection of a coexisting abnormal aortic valve. All patients are advised to practice good oral care.
怀孕
Women with repaired coarctation can carry a pregnancy with low risk. 例外情况是如果有残余的主动脉狭窄或者如果有高血压或者主动脉面积扩大. 最好提前计划，并在怀孕前进行一次彻底的检查，包括主动脉成像研究，以发现这些问题, and control the problems before conception. 请参阅 怀孕 了解更多信息.
我还需要做手术吗?
手术或导尿的需要主要取决于你休息时手臂和腿部的压力水平, 在某些情况下, 在运动中. 如果你的胳膊和腿的血压是正常和相等的，你可能不需要更多的干预. 如果你的血压在你的手臂和超过20毫米汞柱高于你的腿, it is likely further intervention will be needed. 当问题出现时, more and more institutions use catheters rather than surgery, 哪一个对病人来说更容易.
