Coarctation of the Aorta

Coarctation of the aorta:

It is also called aortic coarctation and the condition is where the aorta narrows in the area where the ductus arteriosus inserts.

Types of coarctation:

• Preductal coarctation
• Ductal coarctation
• Postductal coarctation

Preductal coarctation:

This is proximal narrowing to the ductus arteriosus. Blood flow to the aorta that is distal to the narrowing is dependent on the ductus arteriosus; due to which severe coarctation can be life-threatening. This condition results when an intracardiac anomaly during fetal life decreases blood flow through the left side of the heart, in turn leads to hypo plastic development of the aorta. This condition is seen in approximately 5% of infants with Syndrome.

Ductal coarctation:

This condition appears when the ductus arteriosus closes, when narrowing occurs at the insertion of the ductus arteriosus.

Postductal coarctation:

In this condition narrowing is distal to the insertion of the ductus arteriosus as with open ductus arteriosus the blood flow to the lower body can be impaired,this condition is most common in adults. This starts with notching of the ribs, hypertension in the upper extremities, and weak pulses in the lower extremities.

Signs and symptoms:

In few cases children may show no signs or symptoms at first, due to which it cannot be diagnosed until later in life. Few children’s born with coarctation of the aorta have other heart defects too. This condition is twice as common in boys as it is in girls. Just born may not have any symptoms. Few symptoms are listed as:

1. Hard to breath

2. Poor appetite or trouble feeding

3. Failure to thrive

4. Cold arms and legs

5. In later stage it can be problem related to blood flow and heart enlargement

It may also lead to dizziness or shortness of breath, fainting, chest pain, be abnormally tired and get headaches or nosebleeds.

Treatments:

The treatment options depend on age when diagnosed and narrowness of aorta. Other heart defects can also be treated usually, treatment consists of surgery or a procedure called balloon angioplasty.

There are many other open heart surgeries also to treat aortic coarctation like:

1. Resection with end-to-end anastomosis.

2. Patch aortoplasty.

3. Left subclavian flap angioplasty.

4. Bypass graft repair.

5. Balloon angioplasty and stenting