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Outcomes after aortic coarctation repair in neonates weighing less than 2000 g

Victoria Butler1, Zahra Belhadjer2, Régis Gaudin3

  • 1Assistance Publique-Hôpitaux de Paris, Port-Royal Maternity, Neonatal Intensive Care Unit, 123 Boulevard de Port-Royal, 75014 Paris, France; Paris Cité University, Paris, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|September 14, 2023
PubMed

Insights

Delaying surgery for low-birth-weight infants with aortic coarctation does not reduce recoarctation risk. Early repair is crucial to minimize prematurity complications in these vulnerable congenital heart disease patients.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Neonatal Surgery

Background:

  • Preterm birth is common in infants with congenital heart disease (CHD).
  • Management and outcomes for low-birth-weight infants with aortic coarctation are poorly understood.
  • Delayed surgery for weight gain is common, aiming to improve mortality and reduce recoarctation risk.

Purpose of the Study:

  • To evaluate the impact of surgical timing on outcomes in low-birth-weight infants undergoing aortic coarctation repair.
  • To analyze the relationship between birth weight and recoarctation rates.
  • To assess the incidence of prematurity-related complications in this cohort.

Main Methods:

  • Retrospective study of infants weighing <2000g who underwent aortic coarctation repair (Jan 2017-Dec 2020).
  • Analysis of baseline characteristics, medical/surgical management, and outcomes (recoarctation, death, prematurity complications).

Main Results:

  • 15 infants underwent coarctation repair at a median age of 15 days and weight of 1585g.
  • Infants with birth weight <1200g were operated on later but had similar recoarctation rates (26.6%) compared to those >1200g.
  • Higher prevalence of bronchopulmonary dysplasia (40%), intraventricular hemorrhage (40%), and retinopathy of prematurity (27%) in infants <1200g.

Conclusions:

  • Delaying aortic coarctation repair beyond 15 days for weight gain does not decrease recoarctation risk.
  • Delayed surgery may increase exposure to prematurity complications in low-birth-weight infants.
  • Early surgical intervention should be considered for these high-risk infants.
Abstract

Keywords:
Aortic coarctationBronchopulmonary dysplasiaCardiac surgeryIntraventricular hemorrhageNeonatologyPrematurity

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