The aorta is the artery that carries oxygen-rich blood from the lower-left chamber (the left ventricle) to the rest of the body. Coarctation of the aorta means that one area of the aorta is abnormally narrow.

The arteries that carry blood to different parts of the body branch off of the aorta. In children with coarctation, the arteries that branch off before the narrow point receive more blood than the arteries that branch off after it. This increases blood pressure in the arteries that supply blood to the head and arms and decreases blood flow to the legs. The heart is forced to work harder, causing it to get larger. In time, this extra work leads to heart failure.

What are the symptoms?

• Blood pressure that is higher in the arms than in the legs
• Weak pulse or no pulse in the groin area
• Cold legs or feet
• Nosebleeds
• Dizziness
• Fainting
• Leg cramps with exercise

Symptoms usually do not appear until about a week after birth. In a newborn, a narrowed aorta may not be noticed until the ductus arteriosus closes in the days after birth. The narrowing sometimes appears along with other conditions like septal defects and valve problems.

Sometimes coarctation is not diagnosed until late childhood or the teenage years.

With coarctation of the aorta, early detection is important. Coarctation can cause high blood pressure. The longer it goes untreated, the more likely it is that the child will have high blood pressure throughout his or her life.

How is it treated?

Surgery is recommended in most cases. Surgery usually involves removing the narrowed part of the aorta. If this part is small, the two free ends of the aorta can be reconnected after the narrow part is removed. Otherwise, a tube of fabric, a fabric patch, or a flap of tissue may be used to connect the two ends.

To widen the narrowed segment without surgery, doctors may use a catheterization procedure called balloon angioplasty. In this procedure, a long, thin tube called a catheter is inserted into the body, usually in the groin area.  From there, it is guided through an artery up to the narrow part of the aorta. Once inside the narrowed part of the aorta, a tiny balloon on the tip of the catheter is inflated, causing the opening to widen. Then, the deflated balloon and catheter are removed.

More recently, doctors are using wire-mesh devices called stents to support the aorta and keep it open. These stents are implanted during an angioplasty procedure.

See also on this site: Congenital Heart Disease

See on other sites:

American Heart Association
www.americanheart.org
Diseases & Conditions > Children & Heart Disease > Heart Defects > Coarctation of the Aorta

Updated July 2007