Document Type : Case Report
Authors
1 Department of Community Medicine, Ali-Ibn Abi-Talib Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2 Pediatrics Department, Afzalipoor Hospital, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Background: Coarctation of the aorta is a congenital heart disease that can lead to heart failure and severe symptoms during infancy. In many cases, these infants are candidates for surgery or correction of balloon angioplasty of coarctation, which would often lead to the recurrence of stenosis. This article aimed to introduce a successful case of angioplasty and stenting in a 40-day-old infant with coarctation of the aorta and severe heart failure.
Case Report: A 40-day-old infant weighing 4300 g with tachycardia, acute respiratory distress, loud second heart sound (loud S2), and a mild systolic murmur was referred to the Kerman Cardiac Center. Echocardiographic evaluation revealed left ventricular cardiomyopathy, severe coarctation of the aorta, and ejection fraction (EF) of 30%. The pulmonary artery pressure gradient was 50 mm Hg, and the pulses of the lower limb were weak. Given the patient’s conditions, low weight, and young age being less than 3 months, angioplasty with stenting was performed. Despite the infant’s young age and low weight, the stent was placed successfully, and the patient was discharged after 48 hours in good condition, with no complications reported in the follow-ups.
Conclusion: Coarctation of the aorta is a congenital heart defect that will lead to heart failure and death if it is left untreated. Accordingly, early recognition and timely interventions are effective in managing infants with this disease. In this study, stent placement in the infant was safe, improved the patient’s symptoms, and prevented interventions.
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- Ghaderian M, Sabri MR. Report of a coarctation of aorta stenting in an infant. Adv Biomed Res. 2019;8:10. doi: 10.4103/abr.abr_232_18.
- Ghaderian M, Sabri MR, Ahmadi A, Bayat S. Our first experience in stenting of coarctation of aorta in infants and small children; a case series study. ARYA Atheroscler. 2019;15(2):93-8. doi: 10.22122/arya.v15i2.1961.
- Kang SL, Tometzki A, Taliotis D, Martin R. Stent therapy for aortic coarctation in children <30 kg: use of the low profile VALEO stent. Pediatr Cardiol. 2017;38(7):1441-9. doi: 10.1007/s00246-017-1682-x.
- Arfi AM, Galal MO, Kouatli A, Baho H, Abozeid H, Al Ata J. Stent angioplasty for critical native aortic coarctation in three infants: up to 15-year follow-up without surgical intervention and review of the literature. Pediatr Cardiol. 2018;39(8):1501- 13. doi: 10.1007/s00246-018-1922-8.
- Stegeman R, Breur J, Heuser J, Jansen NJG, de Vries WB, Vijlbrief DC, et al. Primary coronary stent implantation is a feasible bridging therapy to surgery in very low birth weight infants with critical aortic coarctation. Int J Cardiol. 2018;261:62-5. doi: 10.1016/j.ijcard.2018.03.009.
- Gorenflo M, Boshoff DE, Heying R, Eyskens B, Rega F, Meyns B, et al. Bailout stenting for critical coarctation in premature/critical/complex/early recoarcted neonates. Catheter Cardiovasc Interv. 2010;75(4):553-61. doi: 10.1002/ ccd.22328.
- Gendera K, Ewert P, Tanase D, Georgiev S, Genz T, Bambul Heck P, et al. Balloon-expandable stents for recoarctation of the aorta in small children. Two centre experience. Int J Cardiol. 2018;263:34-9. doi: 10.1016/j.ijcard.2018.02.054.
- Krasemann T, van Beynum I, Dalinghaus M, van Leuwen W, Bogers A, van de Woestijne P. Indications for stenting of coarctation of the aorta in children under 3 months of age. Neth Heart J. 2020;28(10):546-50. doi: 10.1007/s12471-020- 01371-8.
- Francis E, Gayathri S, Vaidyanathan B, Kannan BR, Kumar RK. Emergency balloon dilation or stenting of critical coarctation of aorta in newborns and infants: an effective interim palliation. Ann Pediatr Cardiol. 2009;2(2):111-5. doi: 10.4103/0974- 2069.58311.
- Feltes TF, Bacha E, Beekman RH 3rd, Cheatham JP, Feinstein JA, Gomes AS, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011;123(22):2607-52. doi: 10.1161/ CIR.0b013e31821b1f10.
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