title: Miniinvasive interventional bridge to major surgical repair of critical aortic coarctation in a newborn with severe multiorgan failure.
abstract: We present a case of a severely ill newborn with complex coarctation, multiorgan failure and massive oedema, who was treated with emergency stenting of the isthmus on the second day of life, which was followed by surgical stent removal and repair of the arch on the 29(th) day, after stabilization of his general status. Interventional percutaneous direct stent implantation was performed, using a coronary stent (Abbott Multi-Link Vision Coronary Stent 3.5 mm/15 mm, USA) to cover the area of the aortic isthmus in the newborn. The area from the origin of the left subclavian artery to the beginning of the descending thoracic aorta beneath the isthmus was widely expanded. Control angiography showed normal size of the isthmus without a systolic gradient in the area. In the next 3 weeks the boy improved his general status, with normalization of liver and renal parameters, as well as resolution of the oedema, and underwent surgery on his 29(th) day of life. The procedure of stent removal with aortic extended end-to-end anastomosis was performed without complications, and the infant was transferred to general paediatrics for further treatment. The strategy of miniinvasive interventional bridge to postpone major surgical repair was effective in the presented infant, with positive final results of both cardiological intervention and subsequent surgical repair.
authors.affiliation: Department of Paediatric Cardiac Surgery, Mikolaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Haponiuk
authors.forename: Maciej
authors.initials: M
authors.lastname: Chojnicki
authors.forename: Mariusz
authors.initials: M
authors.lastname: Steffens
authors.forename: Radosław
authors.initials: R
authors.lastname: Jaworski
authors.forename: Aneta
authors.initials: A
authors.lastname: Szofer-Sendrowska
authors.forename: Jacek
authors.initials: J
authors.lastname: Juscinski
authors.forename: Ewelina
authors.initials: E
authors.lastname: Kwasniak
authors.forename: Konrad
authors.initials: K
authors.lastname: Paczkowski
authors.forename: Jacek
authors.initials: J
authors.lastname: Zielinski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gierat-Haponiuk
keywords: aortic coarctation; interventional cardiology; newborns; paediatric cardiac surgery; stent implantation