Coarctation of the aorta
The narrowed aorta obstructs the flow of blood to the body's organs.
Vascular stents
a and b: uncovered stents.
c and d: covered stents
e: Dilatation balloon
Aortic coarctation stenting
Angiographic images of aortic coarctation before and after stenting.
What is coarctation of the aorta?
Coarctation of the aorta is an abnormal narrowing of the aorta, the large blood vessel that carries blood from the heart to the rest of the body. This limits blood flow to organs and lower limbs. It can be present from birth (congenital coarctation) or develop later in life. The heart has to work harder to push blood through the narrowed part of the aorta.
How to treat coarctation of the aorta?
The interventional solution for coarctation of the aorta is stenting. Stenting reduces blood pressure in this area, thus relieving the heart and improving blood circulation . It widens the narrowed area, allowing blood to flow more freely. This improves perfusion of the abdominal organs and lower limbs, reducing the risk of complications .
Stenting aims to improve quality of life and reduce the risks of cardiac and vascular complications associated with coarctation of the aorta . However, to perform this procedure, one must be able to ensure the accessibility of the femoral approach. The stent is introduced through the femoral artery, which must be of a good caliber. Generally, the stent can be considered after 8 - 10 years. In younger children, surgery will be discussed. In the neonatal period, for a rescue procedure, balloon dilation alone can be performed.
Performing stenting of coarctation of the aorta:
The child must fast for 12 hours before the examination. Stenting of the coarctation of the aorta is performed in the catheterization room. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs arterial punctures in the groin and inserts a thin catheter. The catheter is guided to the narrowed area of the aorta. The stent is deployed there to dilate the aorta. At the end of the procedure, compression is applied for about ten minutes at the groin level and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Food is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check.
Are there any risks associated with coarctation of the aorta stenting?
Despite technical progress and the experience of doctors, cardiac catheterization involves, as with any invasive or surgical procedure, a risk of incidents or accidents:
Allergic complications: Most often linked to the use of iodinated radiological products or local anesthetics. If you have already experienced allergic manifestations, it is imperative to inform your doctor.
Complications at the artery puncture site: This can range from a simple hematoma to a vascular injury or occlusion requiring surgical repair and/or blood transfusion.
Cardiac and vascular complications: During the examination, discomfort, chest pain, palpitations related to a rhythm disorder may occur. Serious complications are very rare. The risk of death is very low.
What follow-up after stenting of coarctation of the aorta?
Stenting requires taking antiplatelet treatment for a period of 6 months.
Antibacterial prophylaxis will be proposed in the event of risky extracardiac procedures during the 6 months following stent implantation.
The child will be able to have a normal school life. He must continue the follow-up with his cardiologist, have a chest scan at 1 year. Depending on the child's growth, it may be necessary to repeat the procedure to dilate the previous stent or add a new stent.
Coarctation of the aorta
Stenting of coarctation of the aorta
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