Coarctation of the Aorta

What is coarctation of the aorta?

Coarctation of the aorta is a narrowing of the aorta, the main artery that delivers oxygen-rich (red) blood to the body. A coarctation is located just past the aortic arch, which has branches providing blood to the head and arms. When this defect is present, blood flow is restricted and the left ventricle of the heart must pump harder to push blood through the narrowed opening. 

In severe cases, this blockage can cause the left ventricle to weaken and make your child very sick. In older children, this blockage can cause the left ventricle to thicken and also cause high blood pressure in the brain. If the muscle becomes too thick and is no longer able to function efficiently and handle its workload, it can eventually fail. If uncorrected, or corrected late, coarctation can result in lifelong high blood pressure.

Coarctation of the aorta occurs in about 6 to 8 percent of all children with congenital heart disease, and twice as frequently in boys. It also occurs in about 10 percent of girls who have Turner syndrome, a chromosomal abnormality.

Seventy-five percent of children with coarctation of the aorta also have a bicuspid aortic valve, in which the aortic valve has two leaflets, instead of the usual three. Other commonly associated defects can include: 

How we care for coarctation of the aorta

Boston Children’s Hospital has vast experience treating infants and children who have coarctation of the aorta. Our team in the Benderson Family Heart Center treats some of the most complex pediatric heart conditions in the world with overall success rates approaching 98 percent — among the highest in the nation for large pediatric cardiac centers. 

The majority of coarctations are treated surgically although we have developed increasing experience with catheter-based interventions as well. Treatment is individualized to the child’s specific anatomy, age, size and other associated cardiac conditions.

Our areas of innovation for coarctation of the aorta

Innovations at Boston Children’s in the treatment of coarctation include:

  • achieving repairs without the heart/lung machine
  • all-natural tissue repairs
  • advanced brain-protection strategies
  • minimally-invasive and catheter-based solutions
  • “hybrid” collaborations between interventional cardiology and cardiac surgery