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.
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.