Submitted By: Jeanine Harrison, Brenda Ridley and Dr. Peter McLaughlin
One of the most exciting advancements in congenital cardiac care is the technology to widen coarctation of the aorta with the use of a stent, which is inserted by way of a catheter procedure. It, most cases, replaces the need for patients to have cardiac surgery to repair their coarctation. This procedure is not offered in all provinces but access to this medical treatment option can be considered by your cardiologist and referrals can be made to an institution, which specializes in this procedure.
What is Coarctation of the Aorta
Coarctation (constriction) of the aorta is a narrowing of the wall of the aorta. The aorta is the main artery exiting the heart that supplies oxygen rich blood to the body. This narrowing makes the heart work harder. This can mean symptoms for you such as high blood pressure in your arms and pains in your legs when you do activity.
How the Procedure is Performed
A small catheter or tube is placed into a blood vessel at the top of your leg and a wire is fed up to the blocked area in the aorta. A balloon is inflated at the site with the stent around it and it opens the area. The stent is left in place after the balloon is removed. You will receive some medication called anesthesia and will be asleep while the balloon is being used. After the procedure is done you are awakened.
What Are Stents
A stent is a small special metal mesh tube that can be opened and will push against the sides of the narrowing in your aorta and hold it open.
Preparation for the Procedure
You may wish to meet the doctor performing the procedure for a review and have a chance to ask any questions you may have. The potential risks will be discussed. In some institutions a video of a patient’s experience is available to be viewed.
You may also wish to meet with a surgeon to review the option of having surgery to correct the narrowing. At this appointment you can discuss the risks and process of surgery.
Your Admission to Hospital
In most institutions you will be admitted on the morning of your procedure and you will be discharged the next morning after a chest xray.
Follow-Up After Discharge
You should see your own Cardiologist 8 weeks after your procedure. At one year you will be asked to have a catheterization test to look at the site to make sure everything is healing well.
What to Expect after Discharge
- You will be able to perform light activity around the house and short walks outside the house for 3-5 days, and then resume usual daily activity.
- You can resume exercise after two weeks.
- You need to avoid strenuous exertion, heavy lifting and sports involving running for 8 weeks.
- Avoid contact sports where chest trauma might be expected for 4-6 months.
- Tylenol can be taken for the usual post procedure chest discomfort, which will settle in 2-3 days.
- Discomfort or some bruising may result from insertion of the catheter into your groin area. Tylenol can be use for this discomfort. Any bleeding at that site needs to be reported to your family doctor or if it seems to be severe you should go to an emergency room in your area.
Tylenol can be taken as directed for chest discomfort for the first 2-3 days. You will need to take antibiotics for the first 6 months prior to any dental work.