AI Summary & Key Takeaways
AI InsightConclusion: Coronary balloons can be used safely with palliative aims in newborns with high surgical mortality risk as a bridge to surgery.
📌 3 Key Takeaways
Abstract
Objective: Critical coarctation of the aorta (CoA) may cause severe left ventricular dysfunction and systemic hypoperfusion in the neonatal period. Surgical treatment in the neonatal period is superior to balloon angioplasty due to lower recoarctation and reintervention rates. However, surgical mortality increases in hemodynamically compromised patients. This has generated interest in emergency palliative balloon angioplasty as a bridge to surgery. The present study reports outcomes of emergency palliative balloon angioplasty performed with coronary balloons due to resource limitations, including the absence of neonatal-specific balloons and inconsistent access to pediatric cardiac centers. Method: Records of all newborns diagnosed with critical CoA [w11.1][OÇ1.2]and undergoing coronary balloon angioplasty were retrospectively reviewed. Results: The study included 14 critical neonates who underwent balloon angioplasty with coronary balloons. After the procedure, 13 of 14 patients with successful balloon use had left ventricular functions to return normalize within the first 24 hours. The diameter of the narrowest site increased from 1.71 to 4.34 mm (p<0.001), the peak-to-peak gradient decreased from 63.5±19 to 20.5±15.1 mmHg (p=0.002), ejection fraction increased from 42.3±9.1% to 68.3±4.7% (p<0.001). Circulatory disorder regressed and laboratory tests improved. After a successful balloon, 4 patients discharged from the hospital without surgery. In 5 patients, surgery was performed in better condition and all of them were discharged and no one developed recoarctation. One patient had second balloon angioplasty performed. Conclusion: Coronary balloons can be used safely with palliative aims in newborns with high surgical mortality risk as a bridge to surgery.