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Aortic coarctation
Most newborns with symptoms will have surgery either right after birth or soon afterward. First they will receive medications to stabilize them.
Children who are diagnosed when they are older will also need surgery. Usually, the symptoms are not as severe, and more time will be taken to plan for surgery.
During surgery, the narrowed part of the aorta will be removed or opened. If the problem area is small, the two free ends of the aorta may be re-connected. This is called anastomosis. If a large part of the aorta is removed, a Dacron graft (a man-made material) or one of the patient's own arteries is used to fill the gap. A tube graft connecting two parts of the aorta may also be used.
Sometimes, balloon angioplasty may be done instead of surgery, but it has a higher rate of failure.
Older children usually need medicines to treat high blood pressure after surgery. Some will need lifelong treatment for this problem.
Coarctation of the aorta can be cured with surgery. Symptoms quickly get better after surgery.
However, there is an increased risk for death due to heart problems among those who have had their aorta repaired. Without treatment, most people die before age 40. For this reason, doctors usually recommend that the patient has surgery before age 10. Most of the time, surgery to fix the coarctation is done during infancy.
Narrowing or coarctation of the artery can return after surgery. This is more likely in persons who had surgery as a newborn.
Complications that may occur before, during, or soon after surgery include:
Long-term complications include:
Call your health care provider if:
Fraser CD Jr., Carberry KE. Congenital heart disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 60.
In: Anderson RH, Baker EJ, Macartney FJ, Rigby ML, eds. Paediatric Cardiology. 3rd. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 46.
Webb GD, Smallhorn JF, Therrien J, et al. Congenital heart disease. Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: chap 61.