Aortic Coarctation in Children

When your child is born with aortic coarctation, it means this main blood vessel is too narrow. This keeps blood from flowing normally through their body. And it causes their heart to pump harder than it should. This can strain their heart and keep oxygen in their blood from reaching vital organs, including their kidneys, liver and gut.

Sometimes, this congenital heart condition has noticeable symptoms right after birth. Or one of the standard tests your child had after birth may have shown signs of a heart condition.

Other times, you may not know your child has aortic coarctation until they get older. Many kids won’t have any obvious symptoms, but their pediatric provider may discover they have high blood pressure or not be able to exercise as well as they’d like. But this discovery can be the first step to getting the best possible treatment results.

What to expect at your child’s first visit

It’s natural to feel a bit nervous when you and your child first meet with their pediatric cardiology providers, whether it’s virtually or in person. That’s why we spend the first part of the visit getting to know each other.

During this appointment, your child’s provider will want to hear your child’s story. This helps them confirm a diagnosis. So, you’ll want to be prepared to answer a lot of questions, particularly if your baby wasn’t diagnosed right after birth. Their provider may ask:

• Has your child had any symptoms and, if so, what are they?
• When did you first notice these symptoms?
• Did you visit your child’s primary care provider when you noticed these symptoms?
• What tests, if any, did the primary care provider order? What were the results?

If this visit is in person, your child’s provider will do a physical examination. They’ll listen to their heart using a stethoscope to look for a distinctive heart murmur.

They’ll also check the blood pressure in your child’s arms and upper body and compare it to that in their legs and lower body. Their provider may also order other tests to help confirm a diagnosis and rule out other conditions — particularly if things in the physical exam may point to a heart condition.

Testing for aortic coarctation in children

If your child needs more tests, they may have imaging tests like:

• Chest X-ray.
• Echocardiogram (echo).
• Heart CT scan.
• Heart MRI.

These tests help us look closely at your child’s heart and see if they have an aortic coarctation or another heart condition. If your child is nervous about having tests, one of our caring child life specialists can help them feel less anxious about it.

Meet Our Aortic Coarctation in Children Team

The best results often come from a meeting of the minds — and skills. That’s why we take a team-based approach to care at Cleveland Clinic Children’s. Your child will have a personalized care team with providers like:

• Pediatric cardiologists.
• Pediatric cardiac surgeons.
• Pediatric cardiothoracic surgeons.
• Pediatric electrophysiologists.
• Pediatric interventional cardiologists.
• Child life specialists.

These and other pediatric providers on your child’s care team work together to confirm their diagnosis and plan highly individualized treatment.

When we plan your child’s treatment, their team will consider:

• Your child’s age and overall health.
• How big and how severe the aortic coarctation is.
• Where the coarctation is on their aorta.
• If there are any other related heart problems.

Medication

If your baby has severe symptoms right after birth, we’ll give them a medication called prostaglandin (PGE-1). This can help partially reduce the effects of coarctation and stabilize them until surgery.

Surgery

Heart surgery is typically the first treatment we do for aortic coarctation. Sometimes, we can remove or patch the coarctation from an incision (cut) in the side of your child’s chest (thoracotomy). Other times, we may need to do it from an incision in front of their chest (sternotomy). The kind of surgery and repair your child will have depends on where the coarctation is and how narrow it has made their aorta.

Cardiac catheterization

Older children who have mild coarctation or who’ve had coarctation return after a previous surgery, may respond to cardiac catheterization. There are different types of this treatment. Known as an intervention, it’s less invasive than surgery. Depending on their diagnosis, your child may have a balloon angioplasty to open the coarctation. We may do this with or without a stent.

Traveling for Children’s Heart Care at Cleveland Clinic

Any medical treatment can be stressful. Especially when it’s for your child. And when you’re traveling for that treatment, you may feel even more overwhelmed. If you’re coming to us from another city, state or country, we make things as easy and convenient as possible. Need a place to stay? We’re on it. Want to grab a bite nearby? Just ask. Feeling lost in the city or on our campus? We have the directions you need. No matter what, we’re here for you.

When you come to us from another country, you won’t feel alone. Our experienced and compassionate Global Patient Services (GPS) team is ready to help you navigate your visit to Cleveland Clinic. Our team connects you with the healthcare providers you need and makes appointments. Need a translator? We have them. And we can even coordinate follow-up care for your child when you return home.

Transitioning to Adult Care

While surgery or interventions can fix an aortic coarctation, these conditions can come back (recur). And once your child has had an aortic coarctation, they’re at risk for other heart problems. That’s why it’s important to make sure your child has regular tests and frequent checkups with their care team. They’ll still need these appointments as an adult. When it’s time to move to adult care, our team will help them seamlessly move to the adult cardiology providers at Cleveland Clinic.

Taking the Next Step

Getting the best care possible for your child is no doubt top of mind when you learn they have a congenital heart condition like aortic coarctation. Cleveland Clinic Children’s cardiology providers offer the most personalized care for kids with heart conditions. But it’s more than that. We know how precious your child is. And that’s why you can rest easy knowing we’ll take care of them like they’re one of our own.