COA Defect: Fixing Charlie’s Heart


NEW YORK CITY, N.Y. (Ivanhoe Newswire) — Babies born with heart defects before the 1980’s often did not make it to adulthood, and those who did faced a difficult surgery, and sometimes a lifetime of restrictions and uncertainty. But new procedures at the hands of the country’s top pediatric surgeons are making a huge difference. COA defect

Little Charlie Lowery and dad, Patrick are perfectly healthy now, but both started their lives with the same life-threatening condition. Thirty-one years ago, Patrick went downhill the day after he was born.

Patrick said, “I started bleeding through my eyes. My kidneys were failing. Everything was shutting down.”

Patrick was born with a heart defect called coarctation of the aorta or COA, a narrowing of the vessel leading away from the heart.

Robert Pass, MD, Division Chief of Pediatric Cardiology at Mount Sinai Hospital in New York City said, “Because of this obstruction the heart has great difficulty getting blood where it needs to go.”

Doctors repaired Patricks’ heart using an artery from his arm. He went on to play sports and live an active lifestyle. Patrick and his wife knew their children would have a ten percent chance of inheriting the condition. Big sister Adriana was born with a healthy heart, but on Charlie’s ultrasound, technicians saw the COA defect.

Patrick’s wife, Pam Lowery, said, “The only thing that made it a little easier, I tell people this and they think I’m crazy. I look at Pat, and he had it. And look at him now.”

Dr. Pass says instead of grafting an artery, Charlie’s surgeons used a new approach called end-to-end anastomosis.

“They literally cut out or resect the area that is narrow, and they take the two normal ends and literally, sew them together,” said Dr. Pass.

Patrick said, “It’s all treatable. This can all be fixed.”

“I forget. I truly, truly forget that this child had surgery,” Pam shared.

Doctors say Charlie’s heart will grow and stretch as he does, meaning a normal life expectancy with very few restrictions. Doctors says a generation ago, only about 50 percent of the patients born with heart defects survived.  With new techniques, more than 95 percent of the children survive.

Contributors to this news report include: Cyndy McGrath, Field Producer; Kirk Manson, Videographer; Jamison Kozcan, Editor.

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REPORT:       MB #4662

BACKGROUND: Coarctation of the aorta, or aortic coarctation, is a narrowing of the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When this occurs, your heart must pump harder to force blood through the narrowed part of your aorta. Coarctation of the aorta is generally present at birth. The condition can range from mild to severe, and might not be detected until adulthood, depending on how much the aorta is narrowed. Coarctation of the aorta often occurs along with other heart defects. While treatment is usually successful, the condition requires careful lifelong follow-up.


COMPLICATIONS: Complications can develop from untreated coarctation of the aorta, the result of long-term high blood pressure caused by the coarctation. Some of the most severe complications include stroke, early-onset coronary artery disease, and brain aneurysm or aortic rupture. If the coarctation is severe and remains untreated for a long period, kidney and liver failure can develop. Despite this, there are many people who are not diagnosed with coarctation until they are being checked for high blood pressure as an adult. More than half of people with coarctation of that aorta also have a congenital heart valve defect.


END-TO-END ANASTOMOSIS: Robert Pass, MD, Division Chief of Pediatric Cardiology at Mount Sinai Hospital in New York City talked about end-to-end anastomosis, ” The benefit is that it is a proven approach that has worked extremely effectively and reliably probably for the last 20 to 30 years. It is the preferred approach by most surgeons. And in the newborn period I would say virtually 100 percent of the time it’s the approach that cardiac surgeons use when there is a discrete coarct, meaning that there is a discrete narrowing in the aorta.” Dr. Pass said he loves being a pediatric cardiologist because, “Patients who have congenital heart lesions in the present era with rare exception can be treated so effectively that the vast majority, well over 95 percent of our patients today, live very full normal lives.”

(Source: Robert Pass, MD)


Tildy LaFarge


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Doctor Q and A

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