The staff of the Adolescent and Adult Congenital Heart Disease Program at Nationwide Children's Hospital are experts in caring for patients with Coarctation of the Aorta and other congenital heart diseases. Our program is comprised of experts with an understanding of congenital heart disease as well as patient care after surgical or specialized transcatheter therapy. A full range of diagnostic and treatment capabilities are available to our patients.
The aorta is the major artery that is responsible for supplying the body with oxygenated (red) blood from the heart. The coronary arteries are the first blood vessels to come off of the aorta and supply oxygen to the heart muscle. The aortic arch then gives rise to arteries that supply blood to the head and arms. The descending aorta (lower portion of the aorta) supplies blood to the lower body.
Coarctation of the aorta is a congenital heart defect where the aorta is narrowed (obstructed) and usually occurs just past the left subclavian artery (supplies blood to the left upper body) and results in decreased blood flow to the lower body. The left ventricle (pumping chamber) of the heart must work harder in order to pump blood through the narrowed aorta.
Often times, coarctation of the aorta is diagnosed in infancy. If the narrowing is severe, a baby may develop poor feeding, poor weight gain, fast breathing, pale or grayish skin color, and shock. In some cases, coarctation of the aorta is not discovered until later in life. A mild narrowing may go undetected for years but may be discovered due to high blood pressure in the arms, low blood pressure in the legs, weak pulses in the groin and feet, heart murmur, leg cramping with exercise, and frequent headaches.
Coarctation of the aorta may also be associated with genetic abnormalities such as Turner syndrome or with other heart problems such as bicuspid aortic valve. Bicuspid aortic valve occurs when two of the aortic valve leaflets fuse together; fusion of the valve leaflets results in abnormal valve opening and closing, and often leads to leaking of the valve. Bicuspid aortic valve may also be associated with enlargement of aortic root (first section of the aorta).
Coarctation of the aorta is usually diagnosed by echocardiogram (ultrasound pictures of the heart). Cardiac magnetic resonance imaging), cardiac CT (computerized tomography scan), and cardiac catheterization angiography also show aortic narrowing. A chest x-ray may show heart enlargement or abnormalities of the ribs caused by enlarged blood vessels that are often associated with coarctation of the aorta. An electrocardiogram (EKG) monitors the electrical activity of the heart and may show signs of heart chamber enlargement.
Several treatment options are available to relieve obstruction from coarctation of the aorta.
In cases of severe obstruction, surgical intervention is necessary. Surgical techniques to correct coarctation of the aorta include:
In some cases, coarctation of the aorta may be alleviated with procedures that do not require surgery and are performed using transcatheter techniques in the interventional cardiac catheterization laboratory.
A balloon is loaded into a catheter that is inserted into an artery in the groin. The catheter is advanced into the aorta and the balloon is inflated in the narrowing to open up the obstruction.
Transcatheter stent therapy
A stent (mesh-like metal tube) is loaded into a balloon catheter and is inserted into an artery in the groin. The catheter is advanced into the aortic narrowing and the balloon is inflated causing the stent to expand and open the area of narrowing.
Despite surgical or interventional catheter based therapies that relieve aortic obstruction, some patients develop long term complications:
Health Promotion and Prevention of Complications
Early identification and treatment of long-term complications is essential in keeping you healthy. This may be achieved by:
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Research Study: Genetic Testing of Individuals & Families with Congenital Heart Disease
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