Stage-by-stage correction of aortic coarctation in low-weight newborns (first experience)
A. V. Nokhrin,
M. I. Komissarov,
I. Yu. Alyoshin,
E. V. Trizna,
L. L. Popova,
O. A. Murashova,
E. M. Gvozd,
D. O. Ivanov https://doi.org/10.24884/0042-4625-2022-181-6-51-57
Abstract
Aortic coarctation in low-weight (less than 2.2 kg) and premature newborns with comorbid conditions is still a current problem of neonatology and cardiac surgery. The closure of the patent ductus arteriosus and the inability to maintain its functioning with prostaglandin medication leads to fatal complications due to a violation of systemic perfusion. Surgical intervention in this group of patients has extremely high risks and unsatisfactory results. In such situations, stage-by-stage correction is a promising direction. Stenting of aortic coarctation allows restoring hemodynamics at the level of the aortic isthmus with minimal risks. In the inter-stage period, it becomes possible to treat comorbid conditions and prepare a patient for radical correction.
About the Authors
A. V. Nokhrin
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Nokhrin Andrey V., Cand. of Sci. (Med.), Head of Cardiac Surgery Service, Cardiovascular Surgeon
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
M. I. Komissarov
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Komissarov Mikhail I., Cand. of Sci. (Med.), Associate Professor of the Department of Pediatric Surgical Diseases named after G.A. Bairov, Doctor of X-ray Endovascular Methods of Diagnosis and Treatment of Microsurgical Department
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
I. Yu. Alyoshin
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Alyoshin Ivan Yu., Cand. of Sci. (Med.), Doctor of X-ray Endovascular Methods of Diagnosis and Treatment of Microsurgical Department
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
E. V. Trizna
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Trizna Evgeny V., Head of the Department of Anesthesiology and Intensive Care for Children with Cardiac Pathology
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
L. L. Popova
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Popova Lilia L., Pediatric Cardiologist, Intensive Care Unit for Children with Cardiac Pathology
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
O. A. Murashova
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Murashova Olga A., Intensivist, Intensive Care Unit
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
E. M. Gvozd
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Gvozd Egor M., Clinical Resident of the Department of Pediatric Surgical Diseases
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
D. O. Ivanov
Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Ivanov Dmitry O, Dr. of Sci. (Med.), Professor, Rector
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest.
References
1. Oster M. E., McCracken C., Kiener A. et al. Long-term survival of patients with coarctation repaired during infancy (from the Pediatric Cardiac Care Consortium) // Am J Cardiol. 2019;124(5):795–802. Doi: 10.1016/j.amjcard.2019.05.047. PMID: 31272703; PMCID: PMC6702038.
2. Krishnamurthy G. Cardiopulmonary bypass in premature and low birth weight neonates – implications for postoperative care from a neonatologist / Intensivist Perspective // Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2019;22:2–9. Doi: 10.1053/j.pcsu.2019.02.009. PMID: 31027559.
3. Hager A., Schreiber C., Nutzl S., Hess J. Mortality and restenosis rate of surgical coarctation repair in infancy: a study of 191 patients // Cardiology. 2009;112(1):36–41. Doi: 10.1159/000137697. PMID: 18580057.
4. Dias M. Q., Barros A., Leite-Moreira A., Miranda J. O. Risk factors for recoarctation and mortality in infants submitted to aortic coarctation repair: a systematic review // Pediatr Cardiol. 2020;41(3):561–575. Doi: 10.1007/s00246-020-02319-w. PMID: 32107586.
5. Lock J. E., Niemi T., Burke B. A., Einzig S., Castaneda-Zuniga W. R. Transcutaneous angioplasty of experimental aortic coarctation // Circulation. 1982;66(6):1280–6. Doi: 10.1161/01.cir.66.6.1280. PMID: 6216025.
6. Singer M. I., Rowen M., Dorsey T. J. Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn // Am Heart J. 1982;103(1):131–2. Doi: 10.1016/0002-8703(82)90539-7. PMID: 6459728.
7. Sen S., Garg S., Rao S. G., Kulkarni S. Native aortic coarctation in neonates and infants: Immediate and midterm outcomes with balloon angioplasty and surgery // Ann Pediatr Cardiol. 2018;11(3):261–266. Doi: 10.4103/apc.APC_165_17. PMID: 30271015; PMCID: PMC6146845.
8. O’Laughlin M. P., Perry S. B., Lock J. E., Mullins C. E. Use of endovascular stents in congenital heart disease // Circulation. 1991;83(6):1923–39. Doi: 10.1161/01.cir.83.6.1923. PMID: 2040045.
9. Mini N., Zartner P. A., Schneider M. B. E. Stenting of critical aortic coarctation in neonates between 600 and 1,350 g. Using a transfemoral artery approach. A single center experience // Front Cardiovasc Med. 2022;9:1025411. Doi: 10.3389/fcvm.2022.1025411. PMID: 36312251; PMCID: PMC9601737.
10. Soinov I. A., Kulyabin Yu. Yu., Gorbatykh A. V. et al. Palliative stenting of aortic coarctation in a newborn patient in critical condition // Circulatory pathology and cardiac surgery. 2019;23(1):78–82. (In Russ.).
11. Simsek B., Karacsonyi J., Brilakis E. S. PK Papyrus: The New Standard for Sealing Large-Vessel Coronary Perforations // Cardiovasc Revasc Med. 2022;43:102–103. Doi: 10.1016/j.carrev.2022.07.006. PMID: 35864000.
12. Karl T. R., Sano S., Brawn W., Mee R. B. Repair of hypoplastic or interrupted aortic arch via sternotomy // J Thorac Cardiovasc Surg. 1992; 104(3):688–95. PMID: 1513158.
13. Coarctation of the aorta : clinical guidelines / Association of Cardiovascular Russian Association of Cardiovascular Surgeons, Association of Pediatric Cardiologists of Russia, Russian Scientific Society of Specialists in Endovascular Diagnostics and Treatment. Moscow, 2015. (In Russ.).
14. Bazylev V. V., Chuprov M. P., Shcheglova K. T., Bofanov D. A., Shcheglov S. E. A clinical case of successful correction of aortic coarctation with hypoplasia of the distal aortic arch in a premature baby with very low birth weight // Pediatrician. 2022;13(4):101–106. (In Russ.). Doi: 10.17816/PED134101-106.
15. Ceo M. D., Park J. J., Yoon T. J. et al. Results of open heart surgery for congenital heart disease in infants with a low body weight less than 2500 g. // Pediatric Cardiology. 2011;32:578–584. Doi: 10.1007/s00246011-9910-2.
16. Grieshaber P., Merbek M, Yashinsky S. et al. Surgical treatment after angioplasty with a high-risk neonatal stent with critical aortic coarctation // World pediatric surgery of congenital heart disease. 2022;13(4):426– 435. Doi: 10.1177/21501351221099933. PMID: 35757941; PMCID: PMC9243453.
17. Radtke W. A., Waller B. R., Hebra A., Bradley S. M. Palliative stent implantation for aortic coarctation in premature infants weighing <1,500 g // Am J Cardiol. 2002;90(12):1409–12. Doi: 10.1016/s00029149 (02)02887-4. PMID: 12480059.
Supplementary files
Review
For citations:
Nokhrin A.V., Komissarov M.I., Alyoshin I.Yu., Trizna E.V., Popova L.L., Murashova O.A., Gvozd E.M., Ivanov D.O. Stage-by-stage correction of aortic coarctation in low-weight newborns (first experience). Grekov's Bulletin of Surgery. 2022;181(6):51-57. (In Russ.) https://doi.org/10.24884/0042-4625-2022-181-6-51-57
Views:
404
Email this article 