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. Transcatheter repair is a type of procedure using a flexible tube, inserted through a puncture of the skin (percutaneously). It can be used to treat the aorta without the need for open heart surgery. It can help to restore normal blood flow through the aorta.
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 also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:
Have had any recent changes in your health, such as an infection or fever
Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)
Are pregnant or think you may be pregnant
Tests before your surgery
Before your surgery, you may need tests such as:
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
Magnetic resonance imaging (MRI) or computerized tomography (CT), angiography, to get more images of the coarctation
Getting ready for your surgery
Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines before the surgery, such as blood thinners and aspirin. If you smoke, you may need to 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.
Not eat or drink after midnight the night before your surgery, unless your doctor says it’s OK.
Follow all other instructions from your healthcare provider.
You will be asked to sign a consent form that 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 doctor about the details of your procedure. In general, you can expect the following:
An intravenous (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.
The healthcare provider will make a small incision in a blood vessel in your groin. He or she will then insert a long, thin wire into this cut. The wire acts as a guide for during the procedure.
The healthcare provider will then insert a thin, flexible tube (catheter) over the wire. It has a tiny deflated balloon on the end. He or she 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.
The healthcare provider will close and bandage the incision site in the groin.
Hair at the incision site may be removed. The area may be numbed with a local anesthesia.
A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the procedure.
After your surgery
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. You may be able to go home the same day. Your healthcare provider will tell you more about what to expect.
After you go home, you may 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 your normal activities when you get home. But don’t do strenuous activities or heavy lifting for several days. Your doctor may give you more instructions.
Your symptoms should get better soon after the procedure. Make sure to keep all of your follow-up appointments. Your doctor may order follow-up tests, which may include 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 transcatheter 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
May 22, 2018
Agarwala BN, Bacha E, Cao QL, Hijazi ZM. Management of coarctation of the aorta. UpToDate.
Ayden, Scott, MD,Sather, Rita, RN