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Treatment for Coarctation of the Aorta
Treatment for Coarctation of the Aorta
Specific treatment for coarctation of the aorta will be determined by the physician based on:
- Age, overall health, and medical history
- Extent of the disease
- Tolerance for specific medications, procedures, or therapies
- Expectations for the course of the defect
- Personal opinion or preference
Coarctation of the aorta is treated with repair of the narrowed vessel. Several options are currently available.
- Interventional cardiac catheterization. The cardiac catheterization procedure may also be an option for treatment. During the procedure, the patient is sedated and a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin and guided to the inside of the heart. Once the catheter is in the heart, the cardiologist will pass an inflated balloon through the narrowed section of the aorta to stretch the area open. A small device, called a stent, may also be placed in the narrowed area after the balloon dilation to keep the aorta open. Overnight observation in the hospital is generally required.
- Surgical repair. Coarctation of the aorta may be repaired surgically in an operating room. The surgical repair is performed under general anesthesia. The narrowed area is either surgically removed, or made larger with the help of surrounding structures or a patch.
Special equipment will be used to help the patient recover, and may include the following:
- Ventilator. A machine that helps the patient breathe while under anesthesia during the operation. A small, plastic tube is guided into the windpipe and attached to the ventilator, which breathes for the patient while he or she is too sleepy to breathe effectively on his or her own. Many patients remain on the ventilator for a while after surgery so they can rest.
- Intravenous (IV) catheters. Small plastic tubes inserted through the skin into blood vessels to provide IV fluids and important medicines that help the patient recover from the operation.
- Arterial line. A specialized IV placed in the wrist, or other area of the body where a pulse can be felt, that measures blood pressure continuously during surgery.
- Nasogastric (NG) tube. A small, flexible tube that keeps the stomach drained of acid and gas bubbles that may build up during surgery.
- Urinary catheter. A small, flexible tube that allows urine to drain out of the bladder and accurately measures how much urine the body makes, which helps determine how well the heart is functioning. After surgery, the heart will be a little weaker than it was before, and, therefore, the body may start to hold onto fluid, causing swelling and puffiness. Diuretics may be given to help the kidneys remove excess fluid from the body.
- Chest tube. A drainage tube will be inserted to keep the chest free of blood that would otherwise accumulate after the incision is closed. Bleeding may occur for several hours, or even a few days after surgery.
- Heart monitor. A machine that constantly displays a picture of the patient's heart rhythm, and monitors heart rate, arterial blood pressure, and other values.
The patient will be kept as comfortable as possible with several different medications; some of which relieve pain, and some of which relieve anxiety.
Adult Congenital Heart Program
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