Having Transcatheter Repair for Coarctation of the Aorta

Coarctation of the aorta is an abnormal narrowing of the aorta. The aorta is the large blood vessel that leads out of the heart. It sends oxygenated blood to the rest of the body. Coarctation may cause too much pressure on the heart. This condition is generally present at birth. In rare cases, it may happen later. Trans-catheter repair is a type of procedure to treat the aorta and restore normal blood flow without the need for open heart surgery. It's done with a thin, flexible tube put through a small cut in the skin (percutaneous).

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines, such as ibuprofen. It includes vitamins, herbs, and other supplements. Also tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection, illness, or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local or general)

• Are pregnant or think you may be pregnant

Tests before your surgery

Before your surgery, you may need tests, such as:

• Chest X-ray to check your lungs and the size of your heart

• Electrocardiogram (ECG) to check the heart’s rhythm

• Blood tests to assess your general health

• Echocardiogram to look at the coarctation and blood flow through the heart

• MRI, CT scan, or angiography to get more images of the coarctation

Getting ready for your surgery

Talk with your healthcare provider about how to prepare for your surgery. You may need to stop taking some medicines before the surgery, such as blood thinners and aspirin. If you smoke, stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also, make sure to:

• Ask a family member or friend to take you home from the hospital. You can't drive yourself.

• Plan some changes at home to help you recover. You may need help at home.

• Follow your provider's instructions on not eating or drinking before your surgery.

• Follow all other instructions from your healthcare team.

You will be asked to sign a consent form. This gives your permission to do the surgery. Read the form carefully. Ask questions if something is not clear.

On the day of surgery

Ask your healthcare provider about the details of your procedure. In general, you can expect the below:

• An IV line will be put in your hand or arm. You will likely be given medicine to make you comfortable and sleepy during the procedure.

• Hair at the incision site may be removed. The area may be numbed with a local anesthetic.

• A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the procedure.

• A healthcare provider will make a small cut (incision) in a blood vessel in your groin. They will then insert a long, thin wire into this cut. The wire acts as a guide during the procedure.

• The healthcare provider will then put a thin, flexible tube (catheter) over the wire. It has a tiny deflated balloon on the end. They will thread the catheter through the blood vessel in the aorta. Continuous X-ray images are used to show exactly where the catheter is.

• The healthcare provider will inflate the balloon inside the narrow part of the aorta. This will stretch the area open.

• A mesh tube called a stent may be left in place in the area. This will help keep the area open.

• The healthcare provider will deflate the balloon and remove the catheter.

• They will close and bandage the incision site in the groin.

After your procedure

After the procedure, you will spend several hours in a recovery room. Your healthcare team will watch your vital signs, such as your heart rate, blood pressure, and breathing. You’ll be given pain medicine if you need it.

You may need to lie flat without bending your legs for several hours after the procedure. This is to help prevent bleeding from the incision site. Your healthcare provider will tell you more about what to expect.

Ask your healthcare team when you will be able to go home. Some people may be able to go home the same day. After you go home, you will likely need to take medicines to help prevent blood clots. You may need to take them for a short time, or take them for a longer time. You may also need to take antibiotics. Your healthcare provider will let you know about any other changes in your medicines. You can take pain medicine at home if you need it. 

You can go back to most of your normal activities when you get home. But don’t do hard activities or heavy lifting for several days while your incision is healing. Your healthcare team may give you more instructions.

Follow-up care

Your symptoms should get better soon after the procedure. Make sure to keep all of your follow-up appointments. You may need follow-up tests, including an ECG or an echocardiogram. You will also need lifelong follow-up care with a cardiologist. This is to watch for possible complications from the procedure. Some people will need a repeat trans-catheter repair or surgery. Follow all of your healthcare provider’s instructions. This includes any advice about medicines, exercise, and wound care.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider

• Swelling or pain that gets worse

• Fluid or blood leaking from the incision site

• Chest pain or trouble breathing (call 911)