Your Child's Coarctation of the Aorta (COA) Surgery

Cross section of heart showing repair of coarctation of the aorta.
After repair of COA, blood flow from the heart to the body is restored to normal.

Heart surgery for COA is done by a pediatric heart surgeon. The surgery lasts about 4 to 6 hours. You may stay in the waiting room during surgery.

  • Before surgery. You’ll be told not to let your child eat or drink for a certain amount of time before surgery. Follow these instructions closely.

  • During surgery. Your child is given medicine (sedative or anesthesia) to help him or her sleep and not feel pain during surgery. A breathing tube is placed in your child’s trachea (windpipe). Special equipment monitors your child’s heart rate, blood pressure, and oxygen levels. In most cases, an incision is made a few inches below the armpit, between the ribs. Sometimes an incision in the middle of the chest is needed to access the aorta. The narrowed area of the aorta is removed. The remaining ends of the aorta are sewn together. Sometimes, part of the artery that goes to the left arm, or a graft of manmade materials may be used to repair the aorta. The chest is then closed.

  • After surgery. Your child is taken to a critical care unit. You can stay with your child during much of this time. He or she may remain in the hospital for 2 to 5 days. When your child is ready to go home, you’ll be told how to care for your child at home. 

Risks and complications of heart surgery include

  • Reaction to sedative or anesthesia

  • Infection

  • Bleeding

  • Problems with the nervous system, such as seizure or stroke 

  • Abnormal buildup of fluid around the heart or lungs

  • Muscle or joint pain

  • Damage to vocal cords or diaphragm

  • Abdominal discomfort and feeding difficulties

  • Abnormal heart rhythm (arrhythmia)

What are the long-term concerns?

  • After repair of COA, most children can be active. They can do sports and other exercise.

  • Follow-up visits with the cardiologist are needed. These visits may happen less often as your child grows older. It is possible that, over time, COA will happen again. Further treatment may be needed either with cardiac catheterization or surgery.

  • Medicine may be prescribed to treat problems such as high blood pressure. Children with repaired COA are at higher risk of high blood pressure over time. 

  • Your child may need to take antibiotics before having any surgery or dental work for 6 months after surgery. This is to prevent infection of the heart or valves. This infection is called infective endocarditis. The cardiologist will give you instructions for this.

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