The narrowing of the aorta in its middle part is called coarctation. This narrowing can have varying severity and extent. In people with this pathology, the upper half of the body receives an excess of blood under high pressure, while the lower half suffers from a lack of blood. The absence of normal pulsation in the legs is one of the main diagnostic criteria for coarctation of the aorta.
Why does coarctation of the aorta occur?
The development of this congenital heart defect is caused by:
- Disorders of embryogenesis, that is, abnormalities in the development of the fetal aorta during the initial stage of its formation
- Displacement of open arterial duct tissue into the lumen of the aorta, narrowing the isthmus
- Genetic abnormalities, accompanied by other genetic defects
Also coarctation of the aorta can be caused by various infectious diseases during pregnancy (such as rubella), taking certain medications, drinking alcohol and smoking.
Coarctation of the aorta (usually the abdominal type) can occur during life. For example, some autoimmune diseases (e.g. Takayasu disease) can cause localized and extended aortic narrowing. It is also known that some genetic diseases can also cause aortic narrowing.
Treatment options for aortic coarctation
Transluminal balloon angioplasty and stenting in coarctation of the aorta have been introduced into clinical practice during the last decades.
Endovascular intervention is indicated when the systolic blood pressure gradient in the area of aortic coarctation is more than 20 mmHg and when repeated aortic coarctation develops. Like many endovascular surgeries, balloon angioplasty and stenting are conducted under the local anesthesia.
Endovascular methods of treatment are currently the method of choice in the treatment of patients with coarctation of the aorta who are in a critical condition and cannot undergo open surgical correction of the defect. Using arterial access to the area of aortic narrowing, a guiding catheter is inserted.
Along with it, a balloon catheter is subsequently inserted, and balloon angioplasty is performed. If necessary, a stent is implanted as well. Endovascular treatment has a low risk of complications and almost no lethal outcomes.
The choice of treatment method depends on the degree of narrowing, the extent and the exact location of the narrowing, as well as the general condition and age of the patient. Currently, surgical treatment is preferred in children under one year of age, and endovascular treatment is preferred in children after 5 years of age and adults.
If the anatomy of the aortic arch allows it and if there are no cardiac anomalies, the surgery is performed without artificial circulation. The area of aortic arch narrowing is isolated and anastomosis is created between the two ends of the vessel. In some cases, prostheses and special patches can be used to create an anastomosis.
Generally, coarctation of the aorta belongs to a small group of malformations, which may tend to recur. The recurrence rate of coarctation is low and does not exceed 5-8%. Symptoms, making the diagnosis, and surgical treatment methods do not differ from those of primary coarctation of the aorta.
Best clinics in the world for the treatment of aortic coarctation
The leading medical centers for the coarctation of aorta treatment are:
- University Hospital Heidelberg
- Charite University Hospital Berlin
- University Hospital Frankfurt am Main
- University Hospital Oldenberg
You can check the detailed information about the best clinics in the world on the Booking Health website.
Treatment abroad during a lockdown
Lockdown has challenged health care systems all around the world. However, hospitals are now used to working in such conditions and are ready to admit international patients.
Booking Health will help you travel to the desired country for treatment, and moreover, the company takes upon itself the preparation for travel and the actual treatment. Booking Health resolves issues with medical visas (which is specifically difficult to get during a lockdown), negotiates with the hospital you choose, books flight tickets and accommodation, and provides other essential services.
If you need the coarctation of aorta treatment, contact Booking Health by sending the request on the official website.