Aortic coarctation is a congenital birth defect involving the aorta, a blood vessel designed to distribute oxygenated blood throughout the body. This condition can occur alongside other malformations of the aorta and heart, or on its own. This condition may be diagnosed at any time from birth throughout childhood, depending on the severity of the defect. The treatment is surgery to correct the defect.
In aortic coarctation, part of the aorta is narrower than it should be. This forces the heart to work much harder to pump blood, causing high blood pressure and eventually leading to heart failure as the overloaded heart becomes unable to function. Aortic coarctation is usually classified by the location of the defect in relationship to the ductus arteriosus, a structure that forms part of the fetal blood circulation and closes up after birth. The aortic birth defect may be preductal, ductal, or postductal, depending on whether it is located before, at, or after the ductus arteriosus.
In patients with a severe defect, as soon as the ductus arteriosus closes, the patient can start going into heart failure as the heart struggles to pump blood. Bluing of the extremities will be observed along with shortness of breath. Surgery is needed as quickly as possible to correct the defect. In older children, high blood pressure may be noted during a routine examination, or the child may report shortness of breath and tingling in the extremities, which can be warning signs of a heart problem.
One option for surgery is a procedure where the narrowed section of the aorta is simply cut out to address the aortic coarctation, with the healthy ends of the vessel being sewn together. Another available treatment is a balloon angioplasty, where an inflatable balloon will be used to push the aorta open and hold it in an open position to allow blood to flow freely through the formerly narrowed area.
Once the aortic coarctation has been treated, the patient should experience an immediate improvement unless there is another underlying medical issue. Issues like shortness of breath and poor circulation to the extremities will be resolved, as the patient's heart will be able to efficiently circulate oxygenated blood to the areas of the body where it is needed. If problems linger after the surgery, it can be a sign of another problem with the patient's heart or circulatory system that went undiagnosed previously.
