Pathophysiology of coarctation of aorta in dichorionic twins with growth discordance

Coarctation of the aorta (CoA) is an abnormal narrowing of the aorta which can occur as an isolated defect or in association with other intracardiac anomalies, in syndromic and non-syndromic patients, with a prevalence of 4 per 1000 live births1. CoA represents a challenge in prenatal diagnostics, and its pathophysiological mechanisms are not well-understood. We report on four dichorionic diamniotic twin pairs presenting with CoA and fetal growth restriction (FGR) in one twin and a discordant phenotype in the cotwin (Table 1).