What is coarctation of the aorta?
Coarctaction of the aorta is a congenital heart defect where the aorta, the main artery that carries blood to the body from the heart, is narrowed. The narrowing in the aorta forces the body to work harder to pump blood to the lower body.
Coarctation of the aorta only affects a small percentage of children with congenital heart disease. Treatment is typically successful, but patients will need regular monitoring with their congenital heart doctors all their lives.
Causes of coarctation of the aortaThe cause of coarctation of the aorta is not known and appears to randomly occur in a developing fetus.
Risk factors for coarctation of the aortaCoarctation of the aorta typically occurs with other congenital heart defects and is more prevalent in boys. If you or your child has any of the heart conditions listed below, he or she is at higher risk to also have coarctation of the aorta.
- Bicuspid aortic valve — occurs when two of the flaps of the aortic valve fuse during fetal development.
- Patent ductus arteriosus (PDA) — a fetal blood vessel that does not close (as it should) but remains open and allows blood to flow from the aorta to the pulmonary artery, common in premature newborns.
- Atrial septal defect
- Ventricular septal defects
- Aortic valve stenosis
- Aortic valve regurgitation
- Mitral valve stenosis
- Mitral valve regurgitation
Symptoms of coarctation of the aorta
Many patients do not have symptoms of coarctation of the aorta until later in childhood or early adulthood. When symptoms do emerge, the most common symptom is high blood pressure.
Other symptoms of coarctation of the aorta include:
- Poor feeding and weight gain
- Low blood pressure
- Enlarged heart
- Heart murmur
- Diminished pulses
- Shortness of breath
- Blue skin from poor circulation
Diagnosis of coarctation of the aorta
Your pediatrician may hear a heart murmur in a regular exam and refer your child to a pediatric cardiologist. Coarctation of the aorta can present similarly to other heart abnormalities; therefore, it is important to consult with the doctor to confirm the diagnosis and develop an appropriate treatment plan.
During a physical exam with your cardiologist, the doctor will listen to your heart and lungs and determine the location of the heart murmur. The location and sound the blood makes will indicate what type of heart condition you or your child has.
Diagnostic tests that may be performed to confirm the diagnosis include:
- Chest x-ray — produces images of the heart and lungs.
- Echocardiogram (echo) — produces a moving picture of the heart and heart valves by using sound waves.
- Electrocardiogram (ECG or EKG) — can detect heart muscle damage or arrhythmias by measuring electrical activity in the heart.
- Cardiac MRI — produces detailed images of the heart and lungs to diagnose aortic coarctation.
- Cardiac catheterization (coronary angiogram) — used to determine the severity of the aortic coarctation as well as to plan surgery for the condition.
Treatment for coarctation of the aorta
The goal of treatment for coarctation of the aorta is to repair the narrowed vessel. It is important to choose a congenital heart surgeon who has experience in treating congenital heart defects.
Minimally invasive procedures to treat coarctation of the aorta include:
- Medication — adults may be given medication to control blood pressure before or after a procedure, babies may be given medication that helps the blood flow until it is repaired via a procedure.
- Balloon angioplasty (catheterization) — a treatment option for patients who have experienced re-narrowing of the aorta after surgery, a balloon is inflated in the narrowed artery to widen the opening.
- End-to-end anastomosis — a cardiothoracic surgeon will remove the narrowed part of the aorta and connect the two ends back together.
- Minimally-invasive coronary bypass surgery (graft repair) — a surgeon will bypass the narrowing by stitching a graft onto the aorta and diverting blood around the defect.