Treatment for coarctation of the aorta
Treatment for coarctation of the aorta is determined by the severity of the narrowing of the aorta and the symptoms.
Infants with severe or tight narrowing of the aorta will be admitted to the hospital, either in the Neonatal Intensive Care Unit or the Pediatric Intensive Care Unit, for close monitoring for signs of poor heart function or decreased blood flow to the lower body. A continuous medication called Prostaglandin may be needed to keep the patent ductus arteriosus open and provide more blood flow to the lower body past the area of the coarctation. Repair of the severe coarctation of the aorta will be necessary before the infant is able to go home.
The coarctation of the aorta is treated with a repair of the narrowed aorta, either during a surgery or sometimes during a cardiac catheterization procedure. The specific type of repair of the coarctation will be determined by the severity of the narrowing, the cardiac symptoms, and the age of the individual.
There are several ways the coarctation can be repaired during the cardiac surgery. Most of the coarctation repair surgeries are done through an incision on the left side of the chest called a thoracotomy.
Surgical options for coarctation of the aorta include:
End-to-end anastomosis: The narrowed area of the coarctation is removed or cut out and the two ends of the aorta vessel are sewn together.
Patch aortoplasty: The narrowed area of the coarctation is opened and a patch is sewn in place to enlarge the size of the aorta.
Subclavian patch: The narrowed area of the coarctation is repaired using a blood vessel called a subclavian artery to widen the narrowed area.
A cardiac catheterization procedure is another option for repair of the coarctation in some individuals. The procedures may include a balloon dilatation (angioplasty) and/or device stent placement at the site of the narrowing.
During the cardiac catheterization, a cardiologist inserts a small catheter or flexible tube into a femoral blood vessel (near the groin area or upper leg area). The catheter is moved towards the heart and the area of the coarctation of the aorta. A catheter with a small balloon is inflated at the site of the narrowing and the area is stretched (or dilated) to increase the size of the aorta. This procedure is called a balloon angioplasty. A stent (or special device) may also be placed in the narrowed area after the balloon dilatation to keep the area opened.
Immediately after the heart surgery, your child will go to our cardiac intensive care unit for close monitoring. Once your child’s medical condition and vital signs are stable, they will transferred from the intensive care unit and continue to receive care on our cardiology floor.
Children’s Mercy has many skilled health care providers to care for your baby. The Neonatal and the Pediatric Intensive Care Units are staffed with doctors and nurses with years of experience who are able to care for the children with all levels of medical needs. The cardiology providers and cardiac surgeons are the heart experts. The cardiac providers will meet with your family and care for you child throughout the hospitalization. The cardiac providers will provide information to you family, assist with the care of your child, and continue to manage your child within the cardiac clinic.
Sometimes, it’s easier to understand how your child’s heart is different if you have a clearer picture of how a healthy heart works. Experts at the Heart Center have provided the basics to help you learn about the heart’s structure and function.
Choosing the best home for your child’s care
The Heart Center at Children’s Mercy provides comprehensive care for your child as they grow. In addition to top-ranked medical care, we will support your entire family through our Thrive program, which gives you resources and care throughout your journey.
When you’re choosing a care team for your child, it can be helpful to see how often our doctors perform certain procedures and how well children do after the surgery is over. Our surgical team performs hundreds of pediatric heart surgeries each year, often with outcomes that are better than the national average. The charts on our Cardiovascular Surgery Outcomes page help you see the number of cases we complete each year, organized by procedure, along with a numerical score that represents our outcomes—how the children did after surgery. The Society of Thoracic Surgeons (STS) score is calculated from a database of surgical outcomes from congenital heart surgery centers across North America. By comparing our numbers to the STS score, you can see how we perform compared to other surgical centers who complete the same types of surgeries.
Learn more about our Heart Center
Care for your growing child
Following your baby’s surgery, they will need close follow-up care with a cardiology provider. These visits will be spaced out as your baby grows. Even though most children lead healthy, active lives, your child will need cardiology care for their whole life.
Your child will be seen by a cardiology provider to monitor for cardiac findings to include hypertension (high blood pressure) and the possible recurrence or the development of narrowing at the site of the surgery or cardiac catheterization treatment.
Your child’s cardiology provider will continue to monitor your child’s heart during clinic appointments. Cardiac tests such as echocardiogram (heart ultrasound), electrocardiogram (heart electrical activity), Cardiac MRI, and exercise stress tests may be recommended.
Since most children will live full lives into adulthood, as they reach an appropriate age, we will help your child transition to an adult congenital heart specialist.