Coarctation of the aorta (COA) surgery | Dr Samson Olori

What is coarctation of the aorta?

Coarctation of the aorta (COA) is a narrowing of the aorta—the main artery that carries blood from the heart to the body. The narrowing is often near where the ductus arteriosus (fetal vessel) closes, and may be related to that process. Blood pressure is higher above the narrowing and lower below; the left ventricle has to work harder and can thicken. In babies, COA can cause heart failure or severe high blood pressure soon after birth. In older children or adults, it may be found when high blood pressure is detected; some have no symptoms. If left untreated, COA can lead to heart failure, rupture or aneurysm of the aorta, and increased risk of stroke or heart attack. It sometimes occurs with other heart defects.

Treatment and follow-up

Repair is recommended when the narrowing is significant or causes symptoms (e.g. heart failure, high blood pressure). In newborns and small infants, surgery is often used: the narrow segment may be removed and the ends joined, or a patch or graft may be used. In older children and adults, balloon dilation and stenting via catheter are often an option and may avoid open surgery. After repair, long-term follow-up is important: blood pressure may remain high (especially if repair was done after early childhood), the narrowing can recur (recoarctation), or the aorta may dilate (aneurysm). We can refer you or your child to a cardiologist or cardiac surgeon for assessment and the best approach.

Diagnosis and life after repair

COA may be suspected when blood pressure is higher in the arms than in the legs, or when a heart murmur or weak leg pulses are found. Echocardiography, MRI, or CT can show the narrowing and its effect on the heart. After repair, many people lead normal, active lives. You will need regular checks of blood pressure and imaging of the aorta to watch for recoarctation or aneurysm. Some people need antibiotics before dental procedures to reduce the risk of heart valve infection. Pregnancy is possible for women with repaired COA but should be planned with a cardiologist. We can refer you or your child to a cardiologist or cardiac surgeon for assessment and the best approach.

Frequently asked questions

Can coarctation be treated with a catheter?
In many older children and adults, balloon dilation and stenting can be used instead of surgery. In newborns and small infants, surgery is often preferred. Your cardiologist will advise.
Will I need long-term follow-up?
Yes. Blood pressure and the aorta should be monitored for life. Some people need further treatment for recoarctation or aneurysm.
Can COA be repaired in adulthood?
Yes. Coarctation can be repaired at any age. It should be treated once diagnosed if the narrowing is significant, to reduce the risk of complications.
What happens if COA is not treated?
Untreated COA can lead to heart failure, high blood pressure, aneurysm or rupture of the aorta, stroke, and heart attack. Repair greatly reduces these risks.