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Coarctation of the aorta (COA) is a congenital birth defect that may develop in infants after pregnant women take Zofran, especially if the medication is taken during the first trimester. COA can be severe and life-threatening without the proper treatment.

What is Coarctation of the Aorta?

COA is a heart condition in which the aorta is narrowed, restricting oxygen-rich blood from moving to the lower part of the body. In turn, the heart works harder to pump the blood through the narrowed part of the aorta. COA can range from mild to serious. The more narrow the aorta is, the more life-threatening the condition becomes. If the aorta is only slightly narrowed, patients may not discover it until a medical checkup in adulthood.
Doctor Examining Crying Baby

In most instances, COA occurs in conjunction with other heart defects and malformations, including the following:

  • Bicuspid aortic valve
  • Aortic valve stenosis
  • Mitral valve stenosis
  • Patent ductus arteriosus

Coarctation of the Aorta Symptoms

COA symptoms will surface depending upon how severe the condition is. Symptoms in severe cases usually surface during early infancy, whereas milder cases of COA may not show any symptoms until the baby is an adult.

The most common symptoms that arise shortly after birth include:

  • Excessive sweating
  • Difficulties with breathing
  • Abnormal fussiness
  • Pale skin

For those with mild narrowing of the aorta, symptoms, as mentioned earlier, may not appear until childhood or adulthood. The most common symptoms include:

  • Headaches
  • Muscle weakness
  • Difficulties with breathing
  • Excessive sweating
  • Nosebleeds
  • Cold feet
  • Leg cramps
  • High blood pressure

Coarctation of the Aorta Diagnosis

Although COA may start developing while your baby is still in utero, it cannot be diagnosed until after birth. If a physician suspects an infant has COA, there are a number of tests used to help confirm a diagnosis, including:

  • Echocardiogram
  • Chest X-ray
  • Magnetic resonance imaging (MRI)
  • Cardiac catheterization
  • Computerized tomography (CT) angiogram
  • Electrocardiogram (ECG)

Coarctation of the Aorta Treatment Options

Treatment options for COA will depend on the age when the condition is diagnosed, as well as how serious the condition is. Typically, however, surgery is the only way to successfully treat COA. There are numerous types of surgery, and your child’s doctor will be able to let you know which option would be the most beneficial.

The most common forms of surgery for COA include:

  • Patch aortoplasty
  • Left subclavian flap angioplasty
  • Bypass graft repair
  • Resection with end-to-end anastomosis

Medication may also be prescribed for COA, but it’s important to note that no medication will cure the condition. Instead, medications work to help control the symptoms and in some instances, to help control blood pressure prior to surgery.

Infants are typically given a medication known as prostaglandin E, a drug used to keep the blood vessels open so that blood flow can get through the narrow opening until surgery is performed.

After surgery, most patients will have high blood pressure. It will return to normal after a while, but blood pressure may run high shortly after the procedure. In addition, sometimes the repaired portion of the aorta may rupture after surgery. Additional surgery may be necessary to correct the rupture.

Coarctation of the Aorta Causes

Although doctors are still uncertain what causes COA, studies suggest that taking Zofran while pregnant increases the risk of infants developing heart defects. Certain heart defects, such as the one mentioned earlier, can lead to additional heart conditions, including COA.

Zofran, also known as Zuplenz or ondansetron, is not intended for use by pregnant women. Yet, physicians across the country continue to prescribe the medication for morning sickness under “off label” use. The FDA, however, has only approved the use of Zofran for surgery and cancer patients. In turn, many women who took Zofran while pregnant are giving birth to infants while a number of serious birth defects, including COA.

Keep in mind that if you took Zofran while pregnant and your baby developed a birth defect, you have the legal right to sue for damages. Currently, GlaxoSmithKline, the makers of Zofran, are facing mounting Zofran lawsuits after women who were prescribed the medication gave birth to infants with birth defects or had to terminate a pregnancy early due to severe fetal abnormalities.