Congenital Heart Disease

Aortic Coarctation

Signs and Symptoms
Diagnosis
Treatment

Treatment

In the past, coarctation repair involved heart surgery through an incision in the side of the chest that required five to seven days in the hospital for recovery. It is now possible to correct coarctation without surgery in a procedure called a cardiac catheterization.

The heart catheterization consists of placing a long, thin, hollow plastic tube, called a catheter, into the blood vessel in the groin and passing it through vessels into the heart's chambers. The catheter is used to gather blood samples, take pressure measurements and inject dye for X-ray movies. Modern imaging technology allows doctors to see where the catheter is going and how the heart is functioning.

The size of the aorta narrowing is measured and an appropriate size stent, an expandable slotted metal tube, is selected. Sometimes, more than one stent will be needed for complete repair. If the narrowing is too close to the head and neck vessels, stent repair may not be possible. Surgical repair would then be necessary and will be scheduled for another time.

After an appropriate stent has been selected, it is placed over a deflated balloon at the catheter's tip. When the balloon reaches the site of the narrowing, it is expanded to widen the artery. The stent is left in place to support the newly widened artery walls and the catheter and balloon are withdrawn.

Complications during the procedure are rare and almost all can be treated immediately. These include blood loss requiring a transfusion, allergic reaction to X-ray dye requiring medication, aneurysm and improper stent position requiring retrieval by catheter or surgery. There is a small risk of blockage of the groin vessels used for catheterization, which ordinarily responds to medication. Complications after the procedure, such as breakage, movement or infection of the stent, are extremely rare.

The catheterization and stent placement take approximately three to four hours. Your child will be admitted to the hospital the morning of the procedure and be discharged the following morning.

Last reviewed in March 2003 by health care specialists at UCSF Children's Hospital.