Coarctation of the Aorta Surgery

Children with coarctation of the aorta can have the condition repaired two different ways: through cardiac catheterization or thoracic surgery. When recommending treatment, specialists with Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, will consider your child’s age, overall health, the site of the narrowing and the level of narrowing in the aorta.

Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana.

The Society of Thoracic Surgeons has rated Norton Children’s Heart Institute’s pediatric heart care among the best in the region. Norton Children’s Heart Institute has a network of remote diagnostic and treatment services in Kentucky and Southern Indiana.

What Happens in Coarctation of the Aorta Surgery?

A number of different surgical techniques can be used to repair a coarctation of the aorta:

  • End-to-end anastomosis: The surgeon removes the narrowed area in the aorta (resection) and reconnects the two ends to each other (anastomosis).
  • Arch advancement: This repair involves reattaching the descending aorta to the ascending aorta and effectively bypassing the coarctation segment, which is tied off. Our cardiothoracic surgeons may choose this type of repair in infants when the aortic arch is small (hypoplastic).
  • Subclavian flap or patch aortoplasty: The surgeon widens the narrowed area with a patch or uses a portion of an artery as a flap to expand the area.
  • Interventional cardiac catheterization: This procedure can be used to widen a coarctation of the aorta. A tiny deflated balloon is attached to the end of a catheter, and the catheter is threaded through a large blood vessel to the coarctation. Inflating the balloon widens the narrowing to improve blood flow.

Coarctation of the Aorta Surgery Complications and After Care

Complications from coarctation of the aorta surgery may include:

  • Coarctation reoccurrence: Coarctation (narrowing) may reappear following surgical repair or balloon treatment. This can happen years after surgery. It is more common (about 10% to 20% of patients) when the procedure is done in a newborn. The rate is much lower for older children who have had coarctation repaired. In these cases, balloon dilation or placing a stent can address the issue, instead of having another surgery.
  • High blood pressure is common after treatment. This can be effectively managed with intravenous (IV) medications, and the high blood pressure can get better while the child is in the hospital. The child may need to take oral high blood pressure medications after going home, and that can be addressed at a future outpatient appointment.

Children treated for coarctation of the aorta will need long-term follow-up with a cardiologist. The cardiologist will look for any issues that can happen later in life, such as renarrowing or high blood pressure. These visits will include a physical exam and blood pressure measurements in the arms and legs.

Why Choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is rated higher by the Society of Thoracic Surgeons than the Norton Children’s Heart Institute Pediatric Cardiothoracic Surgery Program.

  • Norton Children’s Hospital is a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
  • More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, for advanced heart care.
  • Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
  • The Society of Thoracic Surgeons rated Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to treat a range of pediatric heart conditions, including the most severe.
  • Norton Children’s Heart Institute has satellite outpatient offices in Ashland, Bowling Green, Campbellsville, Elizabethtown, Frankfort, London, Madisonville, Murray, Owensboro, Paducah and Shepherdsville in Kentucky; as well as Corydon, Jasper, Madison and Scottsburg in Indiana; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
  • The American Board of Thoracic Surgery has awarded the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
  • The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.
  • Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.
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