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Updated: Jun 3, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Improving prediction of critical coarctation of the aorta in neonates: Key parameters and a novel scoring system
Yi-Fang Wang1, Shuenn-Nan Chiu2, Ming-Tai Lin2
1Department of Pediatrics, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
Background:
Coarctation of the aorta (COA) is a congenital heart defect that is difficult to diagnose prenatally due to high false-positive and false-negative rates. Postnatal assessment is further complicated by a patent ductus arteriosus (PDA), which can mask COA. This study evaluated outcomes and developed a predictive model based on early postnatal echocardiography.
Methods:
We retrospectively analyzed neonates with prenatal suspicion of COA admitted from 2019 to 2022, excluding complex heart defects. Echocardiography was performed within 24 h after birth. Intervention was defined as the need for surgery. Multivariate analysis was used to develop the Neonatal-COA Intervention Score (N-CIS), which was prospectively validated in a 2022-2024 cohort.
Results:
Among 47 neonates, 25 (53%) required surgery for critical COA, while 19 (40.4%) had no COA at follow-up. The intervention group had lower distal transverse arch-to-descending aorta diameter ratio (T/D) (OR, 0.40) and isthmus-to-descending aorta diameter ratio (I/D) (OR, 0.31), as well as a higher frequency of a posterior shelf (OR, 31.5; all P < 0.01). The N-CIS achieved 92% sensitivity and 81.8% specificity at a cut-off of 1.5 (area under the curve, 0.905). In 42 validation cases, sensitivity and specificity were 94.4% and 100%, respectively; all with scores greater than or equal to 1.5 required surgery.
Conclusion:
The N-CIS demonstrated high accuracy in predicting critical COA, supporting early risk stratification and timely intervention.
