Coarctation and Recoarctation of the Aorta: Balloon Angioplasty in the Heart Catheterization Lab

What is a coarctation of the aorta?

The aorta is the large blood vessel that carries blood from the heart to the rest of the body. A coarctation of the aorta is a narrowing of this blood vessel. A coarctation of the aorta means that less blood can flow to the lower part of the body. It can also cause high blood pressure in the arms.

In some children, the narrowing happens again after it has been corrected. This is called recoarctation.

A coarctation or recoarctation of the aorta needs to be expanded so that more blood can flow through it.

What is a balloon angioplasty?

A balloon angioplasty is a procedure to dilate (open up) the narrow blood vessel and increase blood flow. The procedure is done in the cardiac (heart) catheterization laboratory.

Balloon Angioplasty of Coarctation of the Aorta
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A catheter with a deflated balloon on its tip is threaded through a blood vessel in the body up to the heart. When the balloon reaches the area of the coarctation it is inflated to open up the narrow area. The balloon is deflated and the catheter is removed.
What is heart catheterization?

During heart catheterization, the doctor carefully puts a long, thin tube called a catheter into a vein or artery in your child's neck or groin. The groin is the area at the top of the leg. Then, the catheter is threaded through the vein or artery to your child's heart.

The doctor who does the procedure is a cardiologist, which means a doctor who works on the heart and blood vessels. This may not be your child's regular cardiologist.

To learn about heart catheterization, please see "Heart Catheterization: Getting Ready for the Procedure".

What happens during the procedure

The procedure is performed while your child is under a general anaesthetic. This means that your child will be asleep during the procedure.

During the catheterization, the doctor threads a special catheter through your child's blood vessels to the narrowed area. The team takes X-ray pictures and measurements of the coarctation. Then the team threads a deflated balloon on the tip of the catheter to the area of the coarctation. The balloon is then inflated to open up the narrowed area. Sometimes a second larger balloon is used to dilate the area further.

Sometimes the doctor may choose to put in a stent. A stent is a small metal tube made of stainless steel or another type of metal. The stent helps widen the narrowed passage by supporting the walls of the blood vessel to keep it open.

After the coarctation is opened up, the team takes a second set of pictures and measurements. The doctor then takes out the balloons and catheters and covers the cuts on your child's legs with a bandage.

There are small risks of complications from the procedure

Generally, cardiac catheterization is a fairly low-risk procedure, but it is not risk-free. The doctor will explain the risks of cardiac catheterization to you in more detail before you give your consent for the procedure. The most common risks are:

The catheter may break through a blood vessel

There is a very small risk that the catheter may break through a blood vessel or the heart wall. To reduce this risk, we use a type of X-ray called fluoroscopy to see where the catheters are at all times.

Your child may develop a bulge in the artery wall

The balloon stretches the aorta to enlarge the narrowed area. This can weaken the wall of the artery and cause an aneurysm (a bulge in the artery wall). This complication occurs in about 6 of every 100 patients treated by this procedure.

Your child will have an X-ray after the procedure so that the team can tell right away if this complication happens. Your child will have another test 6 months to 1 year after the procedure to monitor the result of the dilation and see if an aneurysm is developing. For the second test, we use magnetic resonance imaging (MRI). This is a technique that uses magnets and a computer to take pictures of the inside of the body.

For general information about the risks of heart catheterization, please see "Heart Catheterization: Getting Ready for the Procedure".

The procedure will take 2 to 3 hours

The procedure usually takes 2 to 3 hours, but it can take longer. After the procedure, your child will go to the recovery room to wake up from the anesthetic.

After the procedure

The cardiologist will let you know when your child can go home. Your child will stay in the hospital for at least 4 to 6 hours after the procedure. Some children can go home on the same day as the procedure, but some children will need to stay in the hospital overnight. If your child needs to stay overnight, he or she will be transferred to the inpatient unit.

For information on what to do after your child goes home, please see "Heart Catheterization: Caring for Your Child After the Procedure."

Your child will need a checkup 6 months after the procedure

Your child will be given an appointment to see their regular cardiologist 6 months after the procedure. Your child may have the MRI scan of the dilated area at the same time.

Write the date and time of your child's appointment here:

 

Key points

  • Balloon angioplasty of coarctation and recoarctation of the aorta is a procedure to widen a narrow part of the aorta. The aorta carries blood from the heart to the rest of the body.
  • There is a small risk that your child will have complications from the procedure. Your child's doctor will explain the risks to you before the procedure.
  • Your child will need to have an anesthetic. Your child may need to stay overnight in the hospital after the procedure.

Jackie Hubbert, BScN

Lee Benson, MD, FRCP(C), FACC, FSCAI

Carrie Morgan, RN, MN

Cindy Wasyliw, RN, BNSc

11/6/2009
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