|How Is It Treated?
When this defect has been diagnosed in a neonate, medicine (prostacyclin E1) to maintain patency of the ductus arteriosus is used to provide adequate perfusion to the lower body organs such as the liver , kidneys and intestines to prevent or limit injury. If the neonate does not have a patent ductus and is critically ill, then an emergency cardiac catheterization procedure to stretch up the coarctation with a balloon may be necessary to allow the neonate to recover before surgical repair can be safely performed. Surgery may be performed to relieve the obstruction in the aorta. There are several ways to achieve this.
In the animation to the left, the coarctation is repaired by removing the part of the descending aorta that contains the obstruction and suturing together the resulting ends (upper arrow).
Notice that, as is usual in Coarctation of the Aorta, the narrowing is directly opposite the Patent Ductus Arteriosus (PDA), the small vessel that connects the aorta to the pulmonary artery. This vessel normally closes soon after birth. In the case shown here, the PDA is removed with the constricted section of the aorta and closed off at the pulmonary artery (lower arrow). This is referred to as an end to end repair. Other types of surgical repair use the left subclavian artery (subclavian flap repair) or patch augmentation of the aorta.
In older children with a newly diagnosed coarctation or re-coarcation after and earlier surgical repair, a stent (rigid tube) may be inserted by means of a catheterization procedure to widen the affected part of the aorta and keep it open. If the aortic valve is deformed, it may also be repaired. Post-operative recovery is usually uncomplicated, involving a hospital stay of from 4 days to 1 week.