Aortic Coarctation
Treatment

In the past, aortic coarctation repair involved heart surgery followed by five to seven days in the hospital for recovery. Today, heart specialists correct coarctation in many patients without surgery using a procedure called cardiac catheterization, which involves threading a thin, flexible tube through a blood vessel to insert a specially designed stent, a small metal mesh tube.

The catheterization and stent placement is performed in our Cardiac Catheterization Laboratory. The procedure takes about three to four hours. Your child will be admitted to the hospital the morning of the procedure and may return home the following morning.

To perform cardiac catheterization, a tiny incision is made in the groin to insert thin, flexible tubes, called catheters. The catheters are directed through blood vessels to the heart. Catheters can carry very small instruments or repair devices, such as a stent.

The size of the restricted aorta is measured and an appropriately sized stent, or expandable metal tube, is selected. Sometimes, more than one stent is needed for the repair. If the narrowing is too close to the head and neck vessels, stent repair may not be possible. In these cases, surgical repair is necessary and will be scheduled for another time.

The stent 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 The stent is left in place to support the newly widened artery walls and the catheter and balloon are withdrawn.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

Complications during the procedure are unusual and most can be treated immediately. These include allergic reaction to X-ray dye requiring medication, aneurysm or bulge in a blood vessel, blood loss requiring a transfusion and an 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. Although very rare, serious complications such as a tear in the aorta, requiring surgery or resulting in death, can occur. Complications after the procedure, such as breakage, movement or infection of the stent, are extremely rare.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated June 17, 2010