Coarctation of the aorta : Treatment

Treatment

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.

Prognosis (Expectations)

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

Complications that may occur before, during, or soon after surgery include:

  • Aortic aneurysm
  • Aortic dissection
  • Aortic rupture
  • Bleeding in the brain
  • Endocarditis (infection in the heart)
  • Heart failure
  • Hoarseness caused by injury to the nerve to the larynx
  • Impaired kidney function
  • Paralysis of the lower half of the body (rare complication of surgery to repair coarctation)
  • Premature development of coronary artery disease (CAD)
  • Severe high blood pressure
  • Stroke

Long-term complications include:

  • Continued narrowing of the aorta
  • Endocarditis (infection in the heart)
  • High blood pressure

Calling Your Health Care Provider

Call your health care provider if:

  • You or your child has symptoms of coarctation of the aorta
  • You develop fainting or chest pain (these may be signs of a serious problem)


Review Date : 11/2/2009
Reviewed By : Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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