Coarctation of the aorta

What is it?

The aorta is the large artery that leaves the heart and distributes blood to the whole body. A coarctation is a localised narrowing of this artery, most often just beyond the vessels that supply the head and the arms. The heart has to work harder to push blood past the narrowing: pressure is high in the arms and flow is reduced in the lower body. It is present from birth and is found either in the newborn or later, when high blood pressure or weak femoral pulses are noted.

Step by step

1. 1

   The work-up includes blood pressure measurement in the arms and the legs, examination of the pulses, an echocardiogram and, depending on age, a CT scan or MRI of the aorta.

2. 2

   The operation is performed under general anaesthesia: your child remains asleep for the whole procedure.

3. 3

   The surgeon reaches the aorta through an incision on the left side of the chest. This procedure does not usually require cardiopulmonary bypass.

4. 4

   The narrowed segment is removed and the two ends of the aorta are stitched together. In some cases the passage is widened with a patch or replaced with a prosthetic tube.

5. 5

   Blood flow is restored and checked, a drain is placed and the chest is closed.

6. 6

   Your child is monitored in intensive care during the first days. Blood pressure is followed closely and treated if necessary.

Recovery and follow-up

Hospital stay usually lasts a few days; the drain is removed early and pain is treated. Activities are resumed gradually, according to the discharge instructions and your child's age. Follow-up includes regular blood pressure measurement in the arms and the legs together with an echocardiogram, since the narrowing can recur over time. This follow-up continues in the long term, including into adult life.