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[Interruption of the aortic arch: a neonatal emergency. Report of 50 cases ]
Insights
Interruption of the aortic arch in neonates is a critical emergency. Early diagnosis and prostaglandin E1 treatment significantly reduce mortality before surgical intervention.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Neonatal Surgery
Context:
- Interruption of the aortic arch (IAA) is a severe congenital heart defect.
- Often presents in neonates with congestive heart failure and shock.
- Frequently associated with other curable cardiovascular anomalies.
Purpose:
- To analyze the outcomes of surgical intervention for IAA in neonates.
- To evaluate the impact of prostaglandin E1 on mortality rates.
- To emphasize the emergent nature of this condition.
Summary:
- A study of 50 neonates with IAA revealed high mortality without surgical intervention.
- Diagnosis was confirmed using ultrasound and angiocardiography.
- Surgical outcomes significantly improved following treatment with prostaglandin E1, reducing immediate and global mortality.
Impact:
- Highlights the critical role of prostaglandin E1 in stabilizing neonates with IAA pre-surgery.
- Underscores the necessity for prompt recognition and management of IAA as a surgical emergency.
- Improved survival rates for neonates with this complex congenital heart defect.
Abstract:
Interruption of the aortic arch, associated with curable cardiovascular anomalies (8 times out of 10) was observed over a period of 8 years in 50 children aged less than 10 days in 80% of cases. They presented with congestive heart failure, with variable degree of shock in most cases, suggesting the diagnoses of left ventricular hypoplasia or coarctation syndrome. Diagnosis was established with ultrasound and angiocardiography. Evolution was lethal in 21 children who were not operated on. 20 children were operated on: before treatment with prostaglandin E1, 9 attempts ended up in 78% immediate mortality and 89% global mortality; after treatment with prostaglandin. E1, these figures were respectively reduced to 45% and 55% (20 cases). This malformation should therefore be recognized as an emergency and then treated with prostaglandin up to surgery.