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Coarctation of the Aorta or Aortic Coarctation

coarctation of the aorta image 

Illustration: Aortic coarctation defect

Coarctation of the aorta or aortic coarctation is a congenital condition. It is a narrowing of the aorta between the upper body branches and the lower body branches.

The aorta carries blood from the heart to the vessels that supply the body with blood and nutrients. If part of the aorta is narrowed, it is hard for blood to pass through the artery.

Coarctation of the aorta can cause high blood pressure in the heart. This can cause the muscle of the heart`s main pumping chamber (left ventricle) to become thick. Eventually, the function of the heart muscle could deteriorate if the condition isn`t treated.

The narrowing of the aorta is typically in an isolated location just after the "arch" of the aorta. The blockage can increase blood pressure in your arms and head, yet reduce pressure in your legs. Abnormalities of the aortic valve may also be present.

Coarctation of the aorta may be seen with other congenital heart defects, such as:

  • Bicuspid aortic valve
  • Defects in which only one ventricle is present
  • Ventricular septal defect

Aortic coarctation is more common in persons with certain genetic disorders, such as Turner syndrome. However, it can also be due to birth defects of the aortic valves.

Signs and symptoms

Symptoms depend on how much blood can flow through the artery. Other heart defects may also play a role.

Around half of newborns with this problem will have symptoms in the first few days of life. In some cases, there may be no symptoms

In milder cases, symptoms may not develop until the child has reached adolescence. Symptoms include:

  • Dizziness or fainting
  • Shortness of breath
  • Pounding headache
  • Chest pain
  • Cold feet or legs
  • Nosebleed
  • Leg cramps with exercise
  • High blood pressure (hypertension) with exercise
  • Decreased ability to exercise
  • Failure to thrive
  • Poor growth

Treatment of coarctation of the aorta

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.

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.

Older children usually need medicines to treat high blood pressure after surgery. Some will need lifelong treatment for this problem.

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