Posts Tagged ‘amato’s coarctation’

Coarctation of aorta  continues to be an  important  acyanotic heart disease  . Now , early recognition  and intervention  is possible with the availability of sophisticated imaging and interventional modalities.

Our understanding of this  entity , even though appears complete  . . . it  is not ,   especially the complexities of the collateral  circulation and the associated malformation.Even in this 21 st century , unexpected circulatory  compromise are reported in the postoperative phase from various vascular  beds (Spinal, mesentric, limbs etc)

It is also  surprising to note ,  much innocuous entities like  ASDs ,VSDs  have  popular  anatomical and functional classification.It is a  rare excercise ,  for cardiology fellows  to classify co-arctation of aorta .This ,  in spite of the fact,  we have a  meticulous classification suggested by Amato , way back in 1991  published in Annals of thoracic surgery .

Let us  be  aware of this  . . .  Click  the link below for Amato’s classification

Amato’s  surgical classification of  coarctation of aorta

Type 1  Primary Aortic Coarctation

Type 2 Coarctation with Isthmus  hypoplasia

Type 3 Coarctation with Tubular hypoplasia of distal arch

3A- With VSD

3B-With complex LV outflow lesions

* Ideally  we need to include BCAV and status of ductus , suitability of aortic stenting in the classification.

Other old classifications

Bonnet’s classification 

Infantile :which later became known as pre-ductal, and adult which later became known as post-ductal . These became obsolete , as we came to know all coarctation or juxta-ductal .(Very difficult to separate into pre or post ductal coarctation  by simply  looking at it  , without knowing the hemodynamics )

Conte et all      **  Backer

1.Isolated coarctation  2.Co- arctation with  VSD 3.Co arctation with complex heart anomalies.



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