About the disease
Aortic coarctation is narrowing of aorta, the biggest artery in the body, responsible for carrying blood from the heart to other organs. It is also responsible for distributing oxygen and other nutrients throughout the body. In coarctation aorta becomes narrowed at some specific point and, as a result, this narrowing can affect the blood circulation of the body and create certain heart problems. Also heart starts to work harder in order to pump out the needed amount of blood and send it through aorta, if this artery is narrowed. Aortic coarctation is most often diagnosed in people with genetic predisposition to this disease. It is believed that aortic coarctation develops as a result of aortic maldevelopment during embryogenesis. Most commonly, it manifests itself in childhood and accounts for 6% of all heart diseases in children. Aortic coarctation is also believed to be more common in boys.
Aortic coarctation in all cases needs to be repaired surgically. 40% of children die during the first two years of their life without proper surgical treatment. Others can live undiagnosed up to 10 years or even to adult years, but the prognosis is very poor if the decision was made not in favour for surgery. People get diagnosed with aortic coarctation in their adult years if the coarctation is so minor that it does not affect the blood circulation. Nonetheless, this condition even in its minor forms can cause other heart problems, such as heart failure. Thus, it needs to be treated to matter the stage.
Symptoms
- High blood pressure
- Chest pain
- Cold skin
- Constant sneezing, which can be explained by lack of oxygen in the body
- Nose bleeding
- Decreased growth of bones in children
Diagnosis
- During a general examination a doctor will listen to patient`s heart to determine if he/she has increased blood pressure, murmurs or any deviations of the heartbeat from normal.
- ECG is used to measure the electrical activity of the heart, which is usually abnormal in aortic coarctation.
- Echocardiogram allows the doctor to get an image of the heart and aorta and determine the location of narrowing, its stage and how much exactly it obstructs the normal blood flow.
Treatment
- Resection with end-to-end anastomosis is a cardiac surgery, during which a surgeon resects the coarctation and then connects two parts of the aorta together, so that the blood circulation is normalized.
- Subclavian flap aortoplasty is a surgical reconstruction of aorta, when a surgeon reassembles aorta by using the healthy graft to rebuild aorta.
- Bypass graft repair is a surgery, which also uses graft, namely healthy veins or arteries to replace the aorta in the place where it is narrowed.
- Patch aortoplasty is a surgery, which aims to widen the coarctation by special synthetic patch.
- Balloon angioplasty and stenting is a surgery, also used to widen coarctation. After the artery is widened by inserting balloon, a surgeon places stent inside the artery to keep it open and prevent it from narrowing in future.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
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