What is postcoarctectomy syndrome in coarctation of the aorta (CoA) repair?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Restoring pulsatile blood flow to the mesenteric arteries may result in mesenteric arteritis, in which the arteries become distended and may rupture. Reflex arteriolar vasoconstriction occurs as part of autoregulation of blood flow and can result in ischemia.

Clinical manifestations may range from mild abdominal discomfort to an acute abdomen with severe abdominal distention, vomiting, ileus, and progression to intestinal wall hemorrhage or perforation. This syndrome may be related to early return to feeding after coarctation repair. Thus, feedings are usually delayed for 48 hours after surgery, and nasogastric tube decompression is continued until feedings are begun slowly and advanced as tolerated. Patients with severe postcoarctectomy syndrome may require exploratory laparotomy for treatment of bowel necrosis or perforation.

Careful monitoring and good control of BP in the postoperative period may reduce the risk of postcoarctectomy syndrome.


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