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Published on: November 19, 2020
[Stent implantation in recoarctation of aorta in infant]
Paweł Dryżek1, Katarzyna Ostrowska, Sebastian Góreczny
1Klinika Kardiologii, Instytut — Centrum Zdrowia Matki Polki, Łódź.
Insights
This case study shows successful stent implantation for infant recoarctation of the aorta, resolving heart failure symptoms and preventing recurrence. The intervention improved aortic isthmus stenosis, ensuring long-term cardiac health.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Critical coarctation of the aorta (CoA) and associated defects require complex management.
- Infants with CoA often face recurrent stenosis after initial treatments.
Observation:
- A 12-month-old infant with critical CoA, arch hypoplasia, and septal defects presented with heart failure (HF) symptoms.
- Previous treatments included surgical correction and balloon angioplasty for recoarctation.
Findings:
- Heart catheterization revealed critical aortic isthmus stenosis.
- Stent implantation in the transverse and descending aorta reduced the gradient from 45 to 0 mm Hg.
- Aortic isthmus diameter increased from 2 to 8 mm, leading to HF symptom regression.
Implications:
- Stent implantation is an effective treatment for recoarctation of the aorta in infants.
- This intervention can lead to long-term resolution of stenosis and improved cardiac function.
- Successful management can prevent HF recurrence and control associated hypertension.
Abstract:
We present the case of a 12 month-old infant with critical coarctaion of aorta, arch hypoplasia, atrial and ventricular septal defects who underwent interventional treatment with stent implantation due to recoarctation of aorta. In neonatal period the patient went through complete surgical correction. At the age of four months balloon angioplasty of recurrent coractation was conducted. Eight months later the patient was hospitalised with heart failure (HF) symptoms. Clinical and echographic examination confirmed critical stenosis of aortic isthmus. We performed heart catheterisation with stent implantation to transverse and descending arch with immediate reduction of gradient from 45 mm Hg to 0 mm Hg, widening of the isthmus from 2 to 8 mm and gradual regression of HF symptoms. At 3 years of observation the patient has not presented with any signs of recurrence of the stenosis. The child remains free of HF symptoms with arterial hypertension controlled with pharmacotherapy and with good left ventricular function on echocardiographic examination.
