Aortic Coarctation
A detailed medical guide on narrowing of the aorta, early symptoms in babies and children, diagnostic tests, surgical/catheter treatment, and long-term outlook.
Normal Aorta
Coarctation (Narrowing)
What is Coarctation of the Aorta?
The aorta is the largest artery (blood vessel) in the body. It carries red oxygenated blood from the heart around the body. Aortic coarctation is narrowing of this blood vessel. It increases the workload of the heart, causing the left pumping chamber (left ventricle) to work harder, which may lead to left ventricular hypertrophy (thickening of the muscle).
Symptoms & Presentation
Affected babies are usually well at birth because blood bypasses the narrowed area via a temporary tube present in foetuses called the ductus arteriosus. This tube closes after birth (usually in the first week).
Once this tube closes, babies with severe coarctation can become unwell as insufficient blood reaches the lower body. Initial signs include feeding difficulties, followed by breathlessness, pallor, and collapse.
Milder forms of coarctation can present later in asymptomatic children via a heart murmur detected during routine checks. High blood pressure (hypertension) is usually a key feature.
Diagnosis
A clinical examination will usually reveal a heart murmur and absent or weak pulses in the legs. An Echocardiogram (ultrasound scan) provides a clear diagnosis of coarctation.
A Chest X-ray and an ECG will also be performed, and some patients may undergo an advanced cardiac MRI or CT scan.
Treatment Options
Unwell babies require immediate treatment with a medicine called prostaglandin to reopen the ductus arteriosus, along with prompt transfer to a specialist paediatric cardiac unit. Dr Naqvi practices at the Royal Brompton Hospital, home to a world-renowned children’s cardiac intensive care unit.
Surgical vs Keyhole Interventions
Babies and young children usually require cardiac surgery to remove the narrowed segment of the aorta. Older children and selected patients may undergo keyhole cardiac catheterisation (balloon dilation or metal stent insertion) under general anaesthesia.
Dr Naqvi works closely with top NICOR-audited congenital cardiac surgeons and interventional cardiologists to select the safest approach for your child.
Cardiac Surgery
Keyhole Catheter
Stent Dilation
Long-Term Prognosis
The outlook for children with coarctation is very good in the vast majority of cases. Lifelong medical follow-up is recommended as recurrence of narrowing can occasionally occur over time.
“Having coarctation of the aorta early in life does not stop children doing well in sports or from having a happy, full life.”
Procedure Animation
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