Aortic coarctation (CoA)

Aortic coarctation (CoA)

The aortic arch, the brachiocephalic trunk, the carotid artery and the subclavian artery sinus, the ductus and the descending aorta are mobilised via a left posterolateral thoracotomy. The aortic arch is clamped distal to the brachiocephalic trunk. In addition, the carotid artery, the subclavian artery and the descending aorta are clamped. The ductus arteriosus is ligated. If the aortic isthmus is effectively narrowed, the narrowed part of the aorta is surgically removed and the remaining ends are sutured together (end-to-end anastomosis). In the newborn, the ductus arteriosus is also closed at the same time. In addition to the end-to-end anastomosis, the most commonly used procedure today, it may be necessary to widen the aorta (e.g. subclavian flap operation). This is always necessary if the constriction is somewhat longer. In the case of an operation in infancy/toddlerhood, scarring can lead to a new narrowing as the patient grows.