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PEDIATRIC SERVICES

Diagnosis & Treatment

Coarctation of Aorta

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How is Coarctation of the Aorta Diagnosed?

Diagnosis

Before a child can be diagnosed with coarctation of the aorta, they must first receive a clinical examination. The doctor will measure their vital signs. If coarctation is suspected, the doctor will note if there is lower blood pressure in the legs. Blood pressure in the leg or feet of the child may seem weak and difficult to read. There is a range of other tests available to confirm a diagnosis of aortic coarctation.

Other tests used for diagnosis are:

  • Chest X-ray. An X-ray of the chest can show an enlarged heart
  • Echocardiogram (EKG). Sound waves are used to create a 3D image of the heart. Doctors can see the heart’s valves which aid in the diagnosis
  • Electrocardiogram (ECG). This test measures the heart’s electrical signals. Electrodes are attached to the skin that can detect irregular heartbeats or show structural abnormalities of the heart.
  • Cardiovascular magnetic resonance imaging (MRI). By using magnetic fields and radio waves, vivid images can be made of the heart. These clearer images are necessary if prior echocardiogram images were not clear enough.
  • Cardiac catheterization. A thin tube called a catheter is inserted into a blood vessel through the groin area. A dye can be used to highlight the areas in question. This test can also reveal any blockage in the blood vessels. Sometimes a small piece of heart tissue is extracted for biopsy in a laboratory.

Coarctation of the aorta can be detected before the birth of the child by performing a fetal echocardiogram. However, the obstruction of the blood flow between the aorta and the pulmonary artery may not be visible in vitro; this condition may not present itself until after the child is born and the ductus arteriosus closes.

How is Coarctation of the Aorta Treated?

Treatment

There are several advanced interventional and surgical procedures used to repair aortic coarctation. Treatment for coarctation of the aorta in children depends on the child’s age and the disease’s severity. Your pediatric cardiovascular team of doctors will discuss which suits your child best. Doctors may begin by prescribing medication to help alleviate some of the symptoms of aortic coarctation.

Medication

Pediatric cardiologists prefer medication as an initial course of treatment to improve heart function for children with this condition. Babies who are affected by severe coarctation of the aorta are prescribed medication that will help keep the ductus arteriosus open. This makes blood flow more easily around the narrowed area while awaiting surgery.

Doctors may prescribe medication to control blood pressure. Surgical repair of the aorta coarctation significantly improves blood pressure, however, many people must continue this regimen even after a successful surgery. Medications are usually used to maintain the flow of blood until surgery can be performed.

Interventional and surgical procedures

  • Balloon angioplasty and stenting. This is usually the first surgical treatment used. It is also done if narrowing occurs after a previous surgery. A small tube called a catheter is inserted into an artery in the groin. An uninflated balloon is placed in the catheter and is guided by X-rays. Once it reaches the area of the narrowing aorta, the balloon is inflated, allowing the artery to open, and let the blood flow. In addition, a small wire mesh tube called a stent is inserted to keep the artery open and prevent future narrowing.
  • Resection with end-to-end anastomosis. This procedure removes the narrowed piece of the aorta and connects the two healthy sections of the aorta.
  • Subclavian flap aortoplasty. A section of the blood vessel that transports blood to the left arm may be used to expand the narrowed section of the aorta.
  • Bypass graft repair. A tube called a graft is used to redirect the blood around the narrowed section of the aorta.
  • Patch aortoplasty. An incision is made across the narrowed section of the aorta. Synthetic material is used to widen the blood vessel. This procedure works well when correcting the long part of the aorta.

Aortic repair surgery is serious and needs to be followed up throughout a person’s lifetime. Constant blood pressure monitoring is necessary and following the doctor’s instructions to avoid complications that can arise.

FAQs

FAQs

Coarctation of the aorta can be repaired with surgery. Symptoms significantly improve after a patient undergoes surgery. Yet, there is still an increased risk of death due to heart problems. Patients should continue to monitor their heart health throughout their life with regular visits to the cardiologist.

The advancements in pediatric cardiology are good news for children affected by coarctation of the aorta. Many children can expect to live normal lives after surgery and treatment. It is recommended that these patients continue to follow up with their cardiologist several times during the year for the rest of their life.

Coarctation of the aorta is a congenital heart defect. It is a heart condition present at birth. Rarely, coarctation of the aorta occurs later in life.

Get Care

Trust NewYork-Presbyterian for coarctation of the aorta treatment

NewYork-Presbyterian understands that caring for a child with coarctation of the aorta is an overwhelming burden for a parent or caregiver. NewYork-Presbyterian offers the most advanced treatments available in pediatric cardiology coupled with the care of the world’s most sought-after pediatric cardiologists.

Schedule an appointment today with one of NewYork-Presbyterian’s compassionate and skilled pediatric cardiologists. Understanding the causes and symptoms of coarctation of the aorta is the first step in finding the most effective treatment for your child’s heart condition.