What is the Treatment for Coarctation of the Aorta (COA) or Aortic Narrowing?
Coarctation of the aorta or aortic narrowing treatment depends on your age at the time of diagnosis and the severity of the aortic narrowing. Other heart defects may be repaired along with coarctation of the aorta or aortic narrowing at the same time.
Treatment approaches for Coarctation of the aorta or aortic narrowing includes a surgery or balloon angioplasty. This is done by a trained doctor in congenital heart conditions and he will evaluate as well as determine the appropriate treatment depending on your condition.
Surgery to Repair Coarctation of the Aorta or Aortic Narrowing
There are open-heart surgical techniques that repair coarctation of the aorta or aortic narrowing. Discussing with your doctor helps in knowing the type you or your child will be repaired. The options include:
- Resection With End To End Anastomosis for Coarctation of the Aorta or Aortic Narrowing: Resection with end to end anastomosis method for coarctation of the aorta or aortic narrowing involves detaching the narrowed aorta segment followed by connecting together the two aorta ends (anastomosis).
- Subclavian Flap Aortoplasty for Coarctation of the Aorta or Aortic Narrowing: In this method for coarctation of the aorta or aortic narrowing, the left sub-clavian artery portion, the blood vessel delivering blood to your left arm, may be used to expand the artery narrowed area.
- Bypass Graft Repair for Coarctation of the Aorta or Aortic Narrowing: Bypass graft repair involves the narrowed area bypassing done by inserting a plastic tube known as a graft between the aorta portions.
- Patch Aortoplasty for Coarctation of the Aorta or Aortic Narrowing: Your doctor may treat you by cutting the narrowed aorta area and then patching a synthetic material to expand the blood vessel. This is useful in case the coarctation involves aorta as the long segment.
Balloon Angioplasty and Stenting to Treat Coarctation of the Aorta or Aortic Narrowing
Balloon angioplasty is to treat coarctation of the aorta or aortic narrowing initially or for curing the re-narrowing (re-coarctation) that occurs after surgery.
In this procedure, your doctor pricks a thin, flexible tube (catheter) into your groin and threads it through blood vessels reaching your heart using the X-ray imaging. An un-inflated balloon is passed through the narrowed aorta opening. Thus, as the balloon is inflated, the aorta expands and blood flows easily. Your doctor in some cases may insert a stent that is a mesh-covered hollow tube in the aorta so that the aorta narrowed part remains open.
Medicines to Treat Coarctation of the Aorta or Aortic Narrowing
There is no medication given to repair coarctation of the aorta or aortic narrowing. However, medications are given to control blood pressure prior to surgery. Coarctation of the aorta or aortic narrowing repairing improves blood pressure, yet medication is advised to be taken for many, even after successful completion of surgery.
Babies having severe coarctation of the aorta or aortic narrowing may be given medication so that the ductus arteriosus is open. This offers a bypass for blood flow until the coarctation of the aorta is repaired around the constriction.
After Treatment Care for Coarctation of the Aorta or Aortic Narrowing
The long-term coarctation of the aorta or aortic narrowing complication is high blood pressure. It falls after the repair of coarctation of the aorta or aortic narrowing, yet is higher than normal.
Occasionally, the aorta segment that is repaired becomes enlarged and weak (aortic aneurysm) that may eventually rupture. In coarctation of the aorta some cases, they recur, after treatment after many years. Having additional surgeries is possible or there are procedures to rectify the re-narrowing or curing other complications.
What is the Recovery Time for Coarctation of the Aorta (COA) or Aortic Narrowing?
The coarctation of the aorta or aortic narrowing symptoms vanish immediately once it is operated correctly and owing to the blockage that results in these symptoms also disappear. People with a bit high blood pressure may need to take medication so that it is in good control.
Kids and teens who undergo surgery feel better after a week or two, and people who had balloon treatment feel better sooner, in a couple of days.
However, doctors recommend patients to avoid physical activities, particularly lifting heavy objects or participating in sports that may cause an impact to the chest for coarctation of the aorta. These activities are not recommended for several months or weeks so that the body gets enough recovery period/healing time. However, in people whose blood pressure is high, may restrict involving in activities unless the blood pressure is not in control.
What Lifestyle Changes are Suggested for Coarctation of the Aorta (COA) or Aortic Narrowing?
Coarctation of the aorta or aortic narrowing may be repaired, yet you must follow-up carefully throughout your life to monitor for recurrences and complications with doctors. Your physician may advice for regular follow-up appointments and to have it checked up with a doctor expert in ACHD (Adult Congenital Heart Disease). Your doctor may evaluate in the follow-up appointments and order imaging tests so that your condition is monitored. In this process, your doctor will check your blood pressure and offer the required treatment.
Here are a few lifestyle changes suggested for coarctation of the aorta or aortic narrowing patients:
- Perform Regular Exercises: Regular exercises help in reducing blood pressure in the condition of coarctation of the aorta or aortic narrowing. You may talk to your doctor if you wish to avoid certain physical activities that may raise your blood pressure temporarily and avoid exercises such as weightlifting. Your doctor may conduct exercise tests before deciding whether you should participate in weightlifting or any other competitive sports.
- Carefully Consider Pregnancy: Prior to becoming pregnant, make it a point to talk to consult your doctor if you will have a safe pregnancy. Women with coarctation of the aorta or aortic narrowing, have higher risk even after repair of aortic rupture, other complications or aortic dissection during pregnancy and delivery. However, doctors assess if your blood pressure is in control or not. If the coarctation of the aorta or aortic narrowing repair is already done and then you become pregnant, you can manage your blood pressure carefully and this is crucial for the health of your baby and you.
- Prevent Endocarditis: Endocarditis refers to the inner lining inflammation of the heart or its structures. This is caused by bacterial infection. Generally, there is no need to take antibiotics prior to certain dental procedures to avoid endocarditis. Conversely, if in the past you had endocarditis or you had prosthetic material during surgery, you may be recommended antibiotics by your doctor. It is best to ask your doctor about the appropriate approach that is suitable for you.