Coarctation of the Aorta

As one of the nation’s top cardiothoracic surgery centers, UT Southwestern Medical Center offers advanced diagnostic and surgical procedures to diagnose and repair coarctation of the aorta.

This congenital heart defect and its related complications are unique to every person, so UT Southwestern’s heart experts tailor treatment to each patient as appropriate.

Experienced Surgeons, Innovative Surgical Options

Coarctation of the aorta (CoA) is a congenital heart disorder in which there is a constriction in the aorta, the body’s largest blood vessel. Because the condition reduces distal blood flow – particularly through the kidneys – it can lead to hypertension (high blood pressure).

Its cause is unknown, but CoA occurs twice as often in men than in women, and it can be fatal in the first few months of life. Depending on the severity of the aortic constriction, CoA might go undetected and undiagnosed until adulthood.

The experienced cardiologists and cardiothoracic surgeons at UT Southwestern expertly evaluate and treat CoA. Our Adult Congenital Heart Disease Program provides complete diagnostic, treatment, and consultative services for patients age 16 and older with all types of congenital heart disease, including those who are newly diagnosed as adults. We offer specialized care that can minimize or prevent complications of congenital heart disease and help patients live longer, healthier lives.

UT Southwestern is also home to a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and can prevent future heart disease.

Symptoms of Coarctation of the Aorta

Symptoms of CoA depend on how much blood is able to flow through the arteries. Symptoms can include:

• Angina (chest pain)
  
• Dizziness
  
• Leg fatigue or cramps
  
• Nosebleeds
  
• Pain with exertion that is relieved by rest
  
• Pounding headache
  
• Shortness of breath
  

Diagnosis of Coarctation of the Aorta

UT Southwestern’s heart doctors might use a number of tests to determine the problem. Tests commonly used to diagnose CoA include:

• Cardiac catheterization: To directly visualize blood-flow restriction at the site
  
• Chest X-ray: To look for “rib-notching” and an enlarged heart
  
• Echocardiography (echo or cardiac ultrasound): To noninvasively visualize the heart and blood-flow obstruction
  
• Electrocardiogram: To test the heart’s electrical signals for signs of left ventricle hypertrophy
• Physical exam: To listen for a mid-systolic heart murmur, determine if blood pressure and pulse are higher in the arms than in the legs, and see if the patient has a well-developed upper body and an underdeveloped lower body

Treatments for Coarctation of the Aorta

Surgery is necessary to treat CoA but can be delayed if the condition isn’t causing signs or symptoms. Surgical procedures used to repair CoA include:

• Percutaneous balloon aortoplasty: To open the narrowed part of the aorta with a balloon catheter, a minimally invasive procedure
  
• Prosthetic patch graft: To widen the aorta by cutting across the constriction and attaching a synthetic patch
  
• End-to-end anastomosis: To remove the narrow portion of the aorta and reconnect the ends
  
• Subclavian flap procedure: To expand the aortic constriction using part of the left subclavian artery, which carries blood to the left arm
  

Support Services

UT Southwestern’s cardiac rehabilitation specialists create customized plans that make nutrition, exercise, and, if necessary, nicotine-cessation programs an integral part of a patient’s daily routine.

Clinical Trials

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.