To explore the echocardiographic characteristics of isolated coarctation of the aorta (COA) and evaluate the value of echocardiography in its diagnosis and follow-up.

A total of 121 patients who were diagnosed with isolated COA from March 2009 to October 2019 were analyzed retrospectively to identify the echocardiographic characteristics of this disease. The echocardiographic parameters included left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), ventricular septum and left ventricular wall thickness, coronary artery diameter, etc. According to the degree of COA, the patients were divided into three groups: mild stenosis (37 cases), moderate stenosis (34 cases), and severe stenosis (50 cases). Among them, 20 patients who underwent surgical repair and were followed for more than 1 year after surgery were analyzed to evaluate the effect of operation by comparing the preoperative and postoperative ultrasound data.

All 121 cases were diagnosed by echocardiography while 3 cases of them were misdiagnosed initially. Other ultrasound findings in our group included increased LVEDd (67/121, 55.4%), decreased LVEF (40/121, 33.1%), left ventricular endocardial thickening (58/121, 47.9%), ventricular septum and/or left ventricular wall thickening (41/121, 33.9%), and left coronary artery diameter widening (12/121, 9.9%). Among them, LVEDd increase, left ventricular endocardial thickening, and LVEF decrease had significant differences between the groups that were divided by stenosis degree (P＜0.05). Twenty patients were followed by echocardiography at 1 day, 6 months, and 1 year after the operation, and compared with preoperative data, the diameter of the repaired lumen was widened, the pressure difference across the stenosis decreased, and the LVEDd decreased at 1 day, 6 months, and 1 year after surgery, with statistically significant differences (P＜0.05). There was no significant change in LVEF 1 day after surgery compared to that before surgery (P＞0.05), but LVEF gradually recovered 6 months and 1 year after surgery, with statistically significant differences compared to that before and 1 day after surgery (P<0.05). Two patients had recoarctation in the 2nd and 8th years after surgery, respectively.

The accuracy of echocardiography in the diagnosis of isolated COA is high. Understanding the echocardiographic characteristics can reduce the occurrence of misdiagnosis. The prognosis of isolated COA is satisfactory after surgical treatment. Echocardiography plays an important role in regular postoperative follow-up of patients with this disease.