Coarctation of the Aorta

What is coarctation of the aorta?

The aorta is the main blood vessel that comes from the heart and supplies blood to the entire body. Coarctation (pronounced koh-ark-TAY-shun) of the aorta is a condition where the aorta has a very narrow area, making it shaped like an hourglass. Blood pressure increases above the narrow spot, and the left ventricle has to pump harder because the pressure is high. The heart may enlarge from this extra work, and its function may suffer if not treated.

Coarctation of the Aorta at Seattle Children’s

  • Consistently ranked one of the nation's best cardiology and cardiac surgery programs by U.S. News and World Report.With more than 40 pediatric cardiologists, we have experience diagnosing and treating every kind of heart problem.

    Our heart team has treated many children with coarctation of the aorta. We have years of experience with the treatment these patients may need, including cardiac catheterization, surgery and hybrid procedures. We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who have catheterization or heart surgery.

    Seattle Children’s has been treating children since 1907. Our team members are trained in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.

    The Adult Congenital Heart Disease Program shared by Seattle Children’s and the University of Washington can help with care throughout your child’s life.

  • When you come to Seattle Children’s, a team of people will take care of your child. Along with your child’s heart doctor (cardiologist), you are connected with newborn specialists (neonatologists), lung doctors (pulmonologists), nurses, child life specialists, social workers and others, if their expertise is needed. We work together to meet all of your child’s health needs and help your family through this experience.

    Read more about the supportive care we offer.

Symptoms of Coarctation of the Aorta

Symptoms of coarctation of the aorta develop because the upper parts of the body get too much blood and the lower parts do not get enough.

In mild cases, where the aorta is slightly narrowed, babies may not have any symptoms.

If babies do have symptoms, they might have these:

  • Working hard to breathe
  • Having poor appetite or trouble feeding
  • Failure to thrive
  • Arms and legs that are cool to the touch

Later on, children may develop symptoms related to problems with blood flow and an enlarged heart. They may:

  • Feel dizzy or short of breath
  • Faint
  • Have chest pain
  • Be abnormally tired
  • Get headaches or nosebleeds
  • Have cold legs and feet, or have pain in their legs when they exercise

In more severe cases, where the aorta is very narrow, babies may develop serious problems soon after birth because not enough blood can get through the aorta to the rest of their body.

Diagnosing Coarctation of the Aorta

Even though the narrow spot exists before birth, this condition may not be diagnosed until a routine exam reveals problems with your child’s pulse or blood pressure.

Your doctor will examine your child, use a stethoscope to listen to their heart and check their blood pressure in their arms and legs. The doctor will ask for details about any symptoms your child has, their health history and your family health history.

To get more information about how their heart looks and works, your child will need some tests.

Your doctor will probably want to use echocardiography and an electrocardiogram.

Sometimes, the doctor needs more information and will use chest X-raysMRI (magnetic resonance imaging) of the heart, CT (computed tomography) scanor angiography. For an older child, the doctor may do exercise testing.

Treating Coarctation of the Aorta

Doctors can treat this condition with cardiac catheterization to open the narrow spot in the aorta (balloon angioplasty) or with surgery to remove that part of the aorta. The treatment plan depends on how severe the coarctation is and if there are other birth defects.

  • Some children can have their narrow aorta opened using catheterization instead of surgery. This method involves inserting a small tube (catheter) through an artery or vein and threading it up to the narrowed area. Then there are 2 options:

    • A balloon can be inserted through the tube. When the balloon is inflated, the aorta is stretched open. Then, the balloon is removed. This is called balloon dilation.
    • A stent can be placed at the narrow spot. A stent is a tube-shaped device that can be left inside a blood vessel to hold it open.
  • These are the options for surgery:

    • Cutting above and below the narrow spot, removing it and joining the loose ends of the aorta together
    • Making a cut in the narrow spot to widen it and sealing it with an artificial patch or a patch taken from an artery in the child’s arm
    • Using a tube to connect the aorta above and below the narrow part

    Read Sabina's story.

  • Some children can have a hybrid procedure, which uses both catheterization and surgery. A cardiac surgeon makes cuts to provide access to the aorta. Then a cardiologist inserts the catheter to open the narrow spot. With this method a child may be able to have catheterization even if they are too small for the tube to be threaded through smaller blood vessels to their aorta.

In addition to these treatments, your child may need medicines to treat problems related to their narrow aorta. These medicines may be used to improve the force of their heartbeat or control their blood pressure.

Transitioning to Adult Care

To meet your child’s long-term healthcare needs, we have a special Adult Congenital Heart Disease Program to transition your child to adult care when they’re ready.

Contact Us 

Contact the Heart Center at 206-987-2515 to request an appointment, a second opinion or more information.

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