For children with coarctation of the aorta — a heart defect in which a narrowed aorta affects the way blood is delivered from the heart to the rest of the body — the team in the Heart Institute at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, provides expert pediatric cardiology and surgical care to repair the defect and improve blood flow.

Why Choose Johns Hopkins All Children’s

The aorta is the main artery that carries blood away from the heart to the rest of the body. Blood vessels branch off the aorta to supply blood throughout the body. Coarctation of the aorta is the narrowing of the main blood vessel that supplies blood to the body.

The coarctation acts similarly to a hose with a kink in it that prevents water from flowing freely through the hose. The “kink” or coarctation of the aorta blocks blood flow to the lower half of the body. This causes high blood pressure in the upper part of the body before the coarctation, and low to no pressure in the lower half.

Children receive comprehensive care from diagnosis to surgical treatment and follow-up care from our expert pediatric cardiologists and board-certified heart surgeons.

Coarctation of the aorta is most often diagnosed after birth. All babies are born with a patent ductus arteriosus (PDA), which is an opening between the pulmonary artery and the aorta that allows blood to flow directly from the heart to the lungs before the baby is born. When a baby has coarctation of the aorta, the PDA helps to supply blood to the lower parts of the body before birth.

A baby’s PDA should close within the first few days after birth, and babies with coarctation of the aorta will begin to show symptoms of the defect. An echocardiogram is used to diagnose the condition, and babies may also need a CT scan, which allows doctors to obtain a more detailed image of the entire aortic arch.

More mild cases may not be detected until the child is older. Your child’s pediatrician may note that your child has high blood pressure or a weaker pulse in their leg and thus may have a coarctation.

Interrupted aortic arch, which is the most severe and life-threatening form of coarctation of the aorta, can often be diagnosed prenatally with a fetal echocardiogram. At Johns Hopkins All Children’s Hospital, our Fetal Heart Program team provides expert diagnosis using fetal echocardiogram as well as management before birth of congenital heart defects.

How We Treat Coarctation of the Aorta

Treatment may depend on your child’s age when they are diagnosed and the severity of their condition. Immediate treatment includes a prostaglandin infusion to keep the ductus arteriosus open. This allows blood flow to the lower body until surgery is done to fix the coarctation or interruption in the aortic arch. Severe cases of coarctation of the aorta, including interrupted aortic arch, require surgery to repair the defect in the first few days of life.

In older children, it may be treated with a procedure to insert a very small balloon to inflate and open the narrowed portion of the aorta to improve blood flow. In adolescents and young adults, a stent (small metal tube) may also be placed after the balloon inflates the affected area to keep the blood vessel open. These procedures are performed by our Interventional Cardiology team.

Follow-up Care

After your child’s surgery, they will be cared for in our cardiovascular intensive care unit. Your child’s blood pressure is monitored to make sure there is no longer a difference between the pressure in the upper and lower parts of the body, and we will perform an echocardiogram to check how your child’s repaired aorta is functioning.

After discharge, your child will continue to be monitored regularly by their pediatric cardiologist. Sometimes the aorta may start to narrow again as the child gets older and older children and young adults who received a surgical repair as babies may require a balloon and/or stent placement later in life.

Adults who have been treated for coarctation of the aorta have a higher risk of developing high blood pressure, early coronary disease, or a re-narrowing of the aorta or dilation at the repair site. Patients can continue to receive care from our experts as adults in the Adult Congenital Heart Disease Program. Adults with congenital heart defects benefit from seeing a provider who understands how congenital heart defects can impact health long term.