Aortic coarctation is one of the most common congenital heart defects. This disease causes narrowing of a part of the aorta, as a result of which little blood passes through it. There are different anatomical types of this heart disease as the aorta can be narrowed in different sites, to different degrees, and at a different length. This is usually a severe heart defect that requires repair in the first year of life. Less commonly, the condition may progress relatively mildly and be detected in adulthood. In any case, heart disease is treated using surgical techniques because it leads to arterial hypertension and heart failure. Symptoms can be controlled with medicines, but without surgery, patients' life expectancy will be greatly reduced. You can have your surgical treatment in one of the German hospitals. You can use the Booking Health service to find out the cost of treatment in Germany and get medical services at the best price.
Content
- Principles of aortic coarctation treatment
- What is patch aortoplasty?
- Advantages and disadvantages of patch aortoplasty for aortic coarctation
- Where to undergo your surgical treatment for aortic coarctation?
Principles of aortic coarctation treatment
Aortic coarctation treatment can only be surgical. There are no medicines that can widen a narrowed section of the blood vessel. Medicines can only be used to maintain hemodynamics while waiting for surgery. In adult patients, medicines may be used to reduce symptoms. Many patients also require medicines to control blood pressure because it can remain elevated even after heart disease has been repaired using surgical techniques.
Surgical treatment for aortic coarctation is performed using different techniques in different patients. Many types of operations and a huge number of their modifications have been developed, which restore hemodynamics by dilating the narrowed section of the aorta, removing it, or creating a bypass for blood flow.
The main treatment options for aortic coarctation include the following:
- resection of the aorta in the area of coarctation with end-to-end anastomosis;
- balloon angioplasty and stenting is an endovascular procedure that involves implanting a stent (tube) inside the narrowed section of the aorta.
The following operations are rarely used in a small number of patients with coarctation:
- resection of the aorta with its replacement;
- end-to-side anastomosis;
- patch aortoplasty;
- subclavian flap aortoplasty, less often aortoplasty with other flaps from the patient's own tissues, for example, the pericardium;
- bypass grafting that involves the formation of an additional path for the movement of blood, bypassing the area of the coarctation.
What is patch aortoplasty?
Surgical treatment for coarctation is aimed at expanding the narrowed section of the patient's aorta. Doctors make an incision in the artery wall in the area of the coarctation. In this case, the diameter of the patient's blood vessel expands, but a defect in its wall is formed. A synthetic patch is used to close the defect, which is sutured to the aorta.
The treatment method is considered outdated. While it has many advantages, the disadvantages outweigh them. Patch aortoplasty has almost never been used in developed countries since the end of the twentieth century. It causes a large number of long-term complications in patients that require revision surgical interventions.
Advantages and disadvantages of patch aortoplasty for aortic coarctation
Patch aortoplasty to eliminate coarctation has many advantages, due to which the technique became widely used in the second half of the 20th century. Its main advantages are the following:
- clamping of the aorta only for a short time;
- a low risk of developing complications from the central nervous system;
- a small area of aortic mobilization;
- virtually zero risk of damage to the lung or spinal cord;
- tissues are sutured together without any tension;
- there is no circular suture, as with end-to-end anastomosis (this is a potential area for the formation of a stricture, which is cicatricial narrowing of the aorta);
- aortic coarctation of considerable length can be eliminated without the use of any vascular prostheses.
The technique of surgical treatment for aortic coarctation, however, has its drawbacks. As a result, it is only used in a small number of patients suffering from this heart disease. In children, the aorta increases over the years, and the synthetic patch remains the same size. As a result, aortic stenosis may develop. In adult patients, minimally invasive balloon angioplasty can be performed instead of heart surgery. If doctors believe that a patient needs open surgery, preference will be given to other options for surgical treatment of heart disease, since aneurysms often occur after the placement of the patch. This is due to the fact that synthetic materials have a higher rigidity as compared to the patient's aortic wall. Artificial tissue does not stretch well, overloading the opposite wall of the blood vessel. In the case of an aneurysm, a patient will need revision surgery to repair it.
Where to undergo your surgical treatment for aortic coarctation?
More and more patients from all over the world prefer to undergo their surgical treatment for aortic coarctation abroad. You can seek medical attention at one of the German hospitals specializing in heart surgery. German doctors successfully treat cardiovascular malformations in patients of any age.
Even if a patient is in a serious condition, doctors in German hospitals can stabilize their condition with medicines or perform a palliative procedure to improve blood circulation. The next stage of treatment is heart surgery, which normalizes hemodynamics. German specialists in the field of cardiovascular surgery successfully deal with any type of coarctation, including a large length of the constriction area, aortic underdevelopment, and a combination of coarctation with other heart diseases.
You are welcome to use the Booking Health website to find out the cost of treatment in Germany, compare prices, and make an appointment for your treatment in Germany. Our website presents the best Departments of Cardiovascular Surgery in German hospitals.
Please leave your request on the Booking Health website to get counseling from specialists in the field of medical tourism. We will find a Heart Surgery Center in Germany, whose doctors specialize in the elimination of aortic coarctation, use innovations, and achieve the best results.
When you make your appointment through Booking Health, the cost of treatment in Germany will be lower for you than when you contact a German hospital directly. The price for the treatment of aortic coarctation in Germany will be reduced due to the lack of additional taxes for foreign patients. Our specialists will make an appointment for you in a German hospital on your preferred dates, arrange your trip, and provide support while you are abroad. The initial cost of treatment in Germany will not increase for you because you will receive health insurance. After the completion of your treatment, we will take care of buying the necessary medicines and forwarding them to your native country. We will also arrange consultations for patients with their attending physician within 3 months after heart surgery, whenever required.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
ECR - European Cardiology Review
American College of Cardiology
Healthline
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