Coarctation of Aorta

Aortic stenosis is a condition in which the aortic valve, which regulates blood flow from the heart to the rest of the body, becomes narrow and restricts blood flow. Aortic stenosis can be caused by a variety of factors, including congenital defects, degenerative changes due to aging, and previous heart valve surgeries.


The symptoms of aortic stenosis can vary from mild to severe, and may include:

  • Chest pain, pressure or tightness, especially during physical exertion.
  • Shortness of breath
  • Fatigue, especially in combination with other symptoms.
  • Fainting or dizziness, especially during physical exertion.
  • Heart murmur


Aortic valve diseases can be present at birth (congenital) or acquired later in life.

Bicuspid aortic valve is the most common genetic abnormality of the aortic valve. A bicuspid aortic valve has two leaflets instead of three. The valve may function well for many years or a lifetime. If stenosis develops or it becomes leaky, the valve may need repair or replacement. Find out more about bicuspid aortic valve.

Aortic valve disease can also be caused by:

  • Age-related buildup of calcium that causes the valve to become narrow and stiff (stenosis)
  • Heart conditions such as a prior heart attack or high blood pressure that can damage the aortic valve
  • High-dose radiation from cancer treatment
  • Infections such as rheumatic fever or infective endocarditis (an infection of inner lining of the heart that can also involve the heart valves)


At the Frankel Cardiovascular Center, our team will work with you to assess your symptoms and make an accurate diagnosis. You will have most of your tests done under one roof and frequently in one visit.

Diagnosing aortic valve disease starts with a health assessment, review of your medical history and physical exam. Your doctor will also listen to your heart for a whooshing sound (murmur), a sign of heart valve disease.

Other tests our doctors use to diagnose aortic valve diseases include:

  • Cardiac computerized tomography (CT) scan which creates a detailed image of your heart and valves using a special type of X-ray.
  • Chest X-ray which shows your aorta and calcium buildup on the aortic valve.
  • Coronary angiography which takes an X-ray of your heart and valves after a special dye is injected into your heart through a catheter inserted into a blood vessel in your arm or groin and guided to your heart.
  • Echocardiogram which produces a video of your heart and valves in action using ultrasound waves. For a closer look, your doctor may order a transesophageal echocardiogram (TEE). A small ultrasound probe is inserted into your esophagus (tube that runs from the throat to the stomach) to get detailed images of your aorta and upper heart chambers.
  • Electrocardiogram (ECG) which tracks the electrical activity of your heart. An ECG can detect an irregular heartbeat and enlarged heart chambers.
  • Exercise or stress ECG test to measures how your heart responds to physical activity. If you cannot exercise, you can take a medication that mimics exercise. 


At the Frankel Cardiovascular Center, treatment of coarctation of the aorta is highly individualized.

In newborns or infants with congestive heart failure, initial treatment is to stabilize the baby with medications that strengthen heartbeat and remove excess body fluids. The most critically ill babies will require the use of a ventilator to help them breathe. Once stabilized, infants with coarctation and congestive heart failure require surgical repair. Our surgeons remove the narrowed segment of aorta and reconnect the ends. Although rare, in some children it is necessary to place a piece of artificial material (Dacron or Gore-Tex) to enlarge or bypass the area of narrowing. Some patients may have a heart catheterization with placement of a special balloon catheter across the narrowed area then inflated to stretch open the aorta.

In children without symptoms, repair of the coarctation, either surgically or using cardiac catheterization and balloon angioplasty, is usually recommended by 18-24 months of age.

In adults, surgical treatment for coarctation of the aorta typically involves repairing or replacing the narrow section of the aorta. The specific surgical procedure used will depend on the location, severity, and underlying cause of the coarctation, as well as  your overall health. The goal of surgical treatment is to relieve the symptoms of coarctation, improve blood flow, and prevent complications, such as aneurysm formation or dissection.

Common surgical options for coarctation of the aorta in adults include:

  • Aortic reconstruction: Our surgeons repair the narrow section of the aorta to restore normal blood flow. This may involve removing the narrowed section of the aorta and suturing the two ends of the aorta back together, or using a patch to cover the narrowed section.
  • End-to-end anastomosis: Surgically connects the two ends of the aorta together to bypass the narrow section. This procedure is typically used when the coarctation is located near the aortic arch.
  • Interposition graft: Surgeons replace the narrow section of the aorta with a synthetic or biological graft. This procedure is typically used when the coarctation is located far from the aortic arch and a direct repair is not feasible.
  • Hybrid procedures: Are a combination of endovascular and open surgical techniques. For example, a stent may be placed to widen the narrow section of the aorta, followed by a surgical repair of the aortic arch to reinforce the stent.

Make an Appointment

To schedule an evaluation with a Frankel Cardiovascular Center physician, call 888-287-1082. Or visit the Make a Cardiovascular Appointment page to learn what to expect when you call us.

Physicians: To refer a patient, call M-Line at 800-962-3555.