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Prior to birth, partially oxygenated blood in the fetus circulates to the aorta via the ductus arteriosus. Coarctation of the aorta will have variable effects depending on the location of the wall thickening.
If this occurs along the aorta distal to the duct (postductal coarctation), the vascular system develops collateral circulation to compensate for poor blood flow to the peripheral tissues. This can occur via the following route: left subclavian artery, internal thoracic artery, intercostal arteries, and descending aorta. Superior and inferior epigastric arteries may also anastamose.
If the disorder occurs proximal to the duct, compensatory pathways may not develop and the infant is in danger of poor circulation to the lower limbs.
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