Coarctation of the Aorta - Complications

Authored by Dr Gurvinder Rull, 09 May 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr John Cox, 09 May 2017

Complications from the surgery

Anyone who has had surgery for coarctation of the aorta will need regular check-ups with a specialist afterwards. Many will have no serious complications due to the surgery and will go on to lead healthy lives afterwards. However, sometimes complications can develop, either at the time of surgery or shortly afterwards. These may include:

  • Internal bleeding during the surgery.
  • Infection of the wound after the surgery.
  • Damage to the kidneys during the surgery.
  • Damage to the spinal cord because of the surgery. This is more likely if the operation is more complicated and the aorta needs to be clamped for a longer period of time. (Because the aorta is clamped, it can stop blood getting through to the spinal cord.) If the spinal cord is damaged, this can mean that the child's legs can become permanently paralysed. This complication is rare but, obviously, can be very serious.
  • A stroke due to the surgery. However, this is also very rare.

Over time, possible complications following surgery

Some other complications are also possible over a period of time after surgery. They can include:

  • Return of the narrowing of the aorta. This is known as recurrent coarctation.
  • An aortic aneurysm. This is a widening, or dilatation, of the aorta. An aortic aneurysm can be a complication of coarctation of the aorta that has not been treated with surgery but it is also a rare complication after surgery. The widened part of the aorta is weaker and there is a risk that it can burst (rupture), causing severe internal bleeding.
  • Persisting high blood pressure despite the fact that the narrowed part of the aorta has been widened or is no longer present. This may need treatment with medication.

Some other complications

Infection can develop at the site of the narrowing in coarctation which can lead to blockage of the opening - this is called endarteritis.

Anyone with coarctation of the aorta (whether they have had surgery or not) has a small risk of getting infective endocarditis. This is an infection that affects part of the tissue that lines the inside of the heart chambers (the endocardium). The infection usually involves one or more heart valves which are part of the endocardium. Infective endocarditis is rare but it is a serious infection that can be life-threatening if it is not detected and treated. See separate leaflet called Infective Endocarditis for more details.

About 4 in 100 people who have coarctation of the aorta also have an aneurysm of one of the small blood vessels in their brain, called a berry aneurysm. As mentioned above, an aneurysm is an abnormally widened, or dilated, part of a blood vessel. The widened part tends to be weaker and there is a risk that it may burst. If a berry aneurysm in the brain bursts, this can lead to bleeding in the brain and a subarachnoid haemorrhage. However, not all berry aneurysms will burst. Symptoms of a subarachnoid haemorrhage can include:

  • A severe headache (often described as feeling like someone has hit you across the back of the head).
  • Being sick (vomiting).
  • Dizziness.
  • Vision problems.
  • A seizure (convulsion).

Pregnancy considerations and precautions

A number of women who have had treatment for coarctation of the aorta go on to have a normal pregnancy with no problems. However, if a woman has coarctation of the aorta, or has had treatment for it, and she is planning to become pregnant, she should discuss this with her heart specialist first. This is because pregnancy can put an extra strain on the heart. It is best to plan a pregnancy when a woman's symptoms and heart condition are stable.

Also, if someone has been born with congenital heart disease, it is more likely that they will have a baby who is also born with congenital heart disease. This risk should be discussed with a heart specialist. It may be possible to arrange for scans of the baby's heart early on in the pregnancy to look for any heart problems.

Further reading and references

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