Treatment of aortic coarctation: surgery/angioplasty is the first option

The complete treatment of coarctation of the aorta is possible only by surgery.

In most cases, surgery is performed as soon as possible after confirmation of the diagnosis.

Surgical treatment may consist of removing the narrowed section of the aorta by joining the two non-narrowed parts of the heart tube.

The usual alternative is catheterisation and the use of special stents (tubes) at the site of the pathology. The stent is then placed in the area of the coarctation, which expands and retains its structure. Balloon angioplasty is also possible.

If the operation is not performed immediately, the patient is given medication to improve blood flow through the lower body until the time of surgery.

Pharmacological treatment also includes drugs for hypertension, which reduce and adjust the patient's blood pressure.

Risks and health complications

Recoarctation and its incidence is reported between 3% and 26% of cases after surgery. Risk factors are surgery within one year of life, anastomosis or angioplasty without stent implantation.

Pseudoaneurysm (a cavity formed by the surrounding tissue of the vessel) is reported more widely. A strong predictor of incidence is surgery using a special patch, when the patch is damaged by pressure and blood flow.

The incidence of pseudoaneurysm formation increases with time and age of the operated patient.

Aneurysms of the cerebral vessels or arteries of the circle of Willis in the brain have been described in 11% of patients diagnosed with coarctation of the aorta. The risk of rupture increases with increasing age and hypertension.

Most patients are asymptomatic. Some patients report headache or photophobia.

Hypertension (high blood pressure) has an incidence of up to 60% in patients 25 years after aortic coarctation surgery. The etiology of hypertension is multifactorial and is related to age, patient health status, and morphological changes in the vasculature.