What is congenital aortic constriction? Aortic constriction is a narrowing of the confines of the aorta and a narrowing of the lumen, resulting in decreased blood flow. Congenital aortic constriction is most commonly seen in the area adjacent to where the ductus arteriosus or arterial ligament joins the aorta, known as the aortic isthmus. Aortic constriction is classified as pre-catheteric, or post-catheteric, depending on the location of the constriction in relation to the ductus arteriosus or ligamentum arteriosum. The pre-catheter type, also known as the infantile type, has an unclosed ductus arteriosus and is often combined with cardiovascular malformations such as ventricular septal defect, patent foramen ovale, atrial septal defect, mitral stenosis, and aortic diastasis. The post-catheter type, also known as the adult type, has a closed arterial duct as an arterial ligament and is rarely combined with other cardiovascular malformations. What are the effects of congenital aortic constriction on the child? Aortic constriction restricts the flow of blood from the heart to the lower part of the body. The pressure proximal to the constriction is elevated and the left ventricle must double its work to allow blood to flow through the stenosis. This results in hypertrophy and damage to the ventricular muscle and even heart failure. Distal to the constriction, blood pressure decreases and blood flow is reduced. In severe cases, renal ischemia and inadequate blood supply to the lower body occur, resulting in hypoxia, oliguria, acidosis, and even death. Part of the lower body blood flow in pre-catheter type aortic constriction comes from venous blood in the pulmonary artery via an unclosed arterial catheter, causing cyanosis in the lower body. How is congenital aortic constriction treated? In principle, once aortic constriction is clearly diagnosed, all should be operated as early as possible to relieve the distal and proximal blood pressure differences of aortic constriction and to avoid damage to cardiac function and other major organs. Aortic constriction can be treated by surgery or catheter intervention. For surgical treatment, simple constriction without other intracardiac malformations is usually treated with a left posterior lateral incision with a fourth intercostal approach to the chest. The constriction can be treated in several ways: one approach is to excise the constricted segment with end-to-end anastomosis, which is currently the most common surgical approach, mainly for newborns and small infants; another approach is to widen the narrowed portion with a patch of its own vessel or artificial material. To perform the intervention, a catheter with a balloon is placed at the narrowed area, and then the balloon is inflated with pressure to widen the narrowed area, and then a stent is placed to ensure that the widened aorta does not retract. In cases of constriction with other intracardiac malformations, the constriction and the intracardiac malformation are usually corrected in one stage with a median incision. Can I participate in sports activities after surgery? Children with no residual stenosis or hypertension can participate in normal activities after the constriction is released. Some children with residual stenosis, hypertension, myocardial abnormalities, or a combination of other cardiac anomalies will need to have their physical activity appropriately limited. What else should the child be aware of in the future? Surgical results are satisfactory, but long-term follow-up is required. Aortic constriction may recur or form an aneurysm and require reoperation or intervention. Hypertension may persist in some patients after the narrowing is resolved.