Coarctation of the aorta in the incidence of ranks fourth among all congenital heart defects - 8%. In men, coarctation of the aorta occurs 2.5 times more frequently than women.
The aorta is the largest vessel in the body. It starts from the left ventricle and carries oxygen-rich arterial blood from the heart to the body. Coarctation (narrowing) of the aorta occurs as isolated or in combination with other heart defects. Most children coarctation of the aorta combined with patent ductus arteriosus, a smaller amount - with ventricular septal defect, and a small percentage of children - the evils of the mitral valve and left ventricular hypoplasia. Most often, the aorta is narrowed to the so-called typical place in the descending portion of the aortic arch, at least in the area of the diaphragm or the abdominal aorta tapers.
90% of deaths of children under one year is associated with coarctation of the aorta. The average life expectancy of patients without surgery about 40 years. The degree of narrowing of the aorta may be different. Sometimes there are multiple restrictions throughout the aorta. Because of the narrowing of the aorta in the left ventricle pressure rises sharply, because it requires much more effort to the left ventricle, which would push the blood through the narrowed aorta. Blood pressure in the vessels of the head, heart, upper extremities, and rapidly increases up to 200 mm Hg. The lower limbs are in heart failure, the pressure in the vessels leading from the aorta below the constriction of the aorta is reduced. The blood supply of the lower extremities is compensated by detours - the development of collaterals from the intercostal and internal mammary arteries. High blood pressure is treatable. He even called malignant hypertension and can cause life-threatening complications.
There are four types of coarctation of the aorta:
isolated narrowing of the aorta
narrowing of the aorta combined with patent ductus arteriosus
narrowing of the aorta combined with ventricular septal defect
narrowing of the aorta, in combination with other malformations of the heart.
In infants the diagnosis difficult. Suggest the existence of aortic coarctation in infants with heart failure. Usually the disease is detected after the detection of high blood pressure. In adults, there are complaints of headaches, nosebleeds, fatigue in the legs. During this congenital heart disease and unfavorable mix it with other malformations aggravates the patient's condition.
Coarctation of the aorta - Diagnosis
A characteristic feature of vice is a significant difference in blood pressure in the arms and legs, lack of pulse in the vessels of the legs. Clarify the diagnosis with echocardiography and study of the aorta with contrast agents.
Treatment of aortic coarctation
In order to avoid the development of life-threatening complications of aortic constriction to be operative treatment. The optimum age of children for surgery from 7 to 10 years. According to some other clinics from 7 to 15 years. In critical condition of the child operation can be performed in infancy. In this case the restricted area of plastic aortic graft the left subclavian artery child. At older ages, may be carried out removing the narrowed area and a simple cross-linking parts of the aorta "end to end." Sometimes the graft. The most dangerous complication of aortic surgery correct narrowing circulatory disorders of the spinal cord. In 0.4% of cases arise persistent paralysis of the lower extremities.
The average mortality for this operation, about 9%. The results of surgery are good. However, throughout the life of patients are advised to limit physical activity.