Coarctation of the aorta is a condition that someone is born with (congenital). It happens when the fetal heart doesn’t develop normally during the first two months of pregnancy. This occurs when there is abnormal development of the aorta before birth. The aorta is the large artery that carries oxygen-rich (red) blood to the body. In coarctation, it is narrower than it should be, making it harder for the heart (left ventricle) to pump blood past the narrowing. Depending on the amount of narrowing, it can present at different ages from newborn to adults. 

Coarctation of the aorta can cause several problems, including:

• The left ventricle that pumps blood to the body cannot squeeze/pump well due to overwork.
• Blood pressure is higher above the narrowing (right arm) and lower below the narrowing (leg).
• In severe narrowing, it can be hard for the organs in the abdomen (kidneys, liver, intestines) to get enough blood flow and it can cause organ failure or feeding problems in the newborn. 
• High pressure can weaken the walls of the heart. That can lead to uncontrollable bleeding or stroke.
• There is an increased risk of developing an infection of the valves of the heart or aorta. This is called bacterial endocarditis.
• The coronary arteries, which supply oxygen-rich (red) blood to the heart muscle, may narrow in response to long-standing elevated pressure.

Specific treatment for coarctation of the aorta will be determined by your child's physician based on:

• Your child's age, overall health and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the defect
• Your opinion or preference

When treating coarctation of the aorta in infants, some will be very sick and require care in the cardiac intensive care unit (CICU). Some may even need emergency surgery. Others, who are exhibiting few symptoms, will have the repair scheduled on a less urgent basis.

There are two options to treat coarctation of the aorta:

Surgery
The narrowed area is either surgically removed or made larger with the help of surrounding structures or a patch.

Cardiac Catheterization
A small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin and guided to the inside of the heart. Once the catheter is in the heart, the cardiologist will pass a small balloon to the narrowed section of the aorta. They will then inflate the balloon to stretch the area open. A small device, called a stent, may also be placed in the narrowed area to keep the aorta open.