Vol. 29 No. 1 (2025)
CASE REPORTS

Stenting of critical aortic coarctation in newborn: a case series

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  • A.A. Rumyantseva,
  • R.S. Tarasov,
  • I.K. Khalivopulo,
  • P.A. Shushpannikov,
  • E.O. Grishacheva
A.A. Rumyantseva
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
Bio
R.S. Tarasov
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
I.K. Khalivopulo
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
P.A. Shushpannikov
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
E.O. Grishacheva
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
DOI: https://doi.org/10.21688/1681-3472-2025-1-99-109

Published 2025-04-28

Keywords

  • Case Reports,
  • Coarctation Stenting,
  • Critical Aortic Coarctation,
  • Neonatal Coarctation

How to Cite

Rumyantseva, A., Tarasov, R., Khalivopulo, I., Shushpannikov, P., & Grishacheva, E. (2025). Stenting of critical aortic coarctation in newborn: a case series. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 29(1), 99–109. https://doi.org/10.21688/1681-3472-2025-1-99-109

Copyright (c) 2025 Rumyantseva A.A., Tarasov R.S., Khalivopulo I.K., Shushpannikov P.A., Grishacheva E.O.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Introduction: Critical neonatal coarctation of the aorta is one of the most formidable heart defects due to the high risk of ischemic organ injury and the development of multiple organ failure. Such a cohort of patients always requires a search for alternative treatment methods that will reduce the risk of fatal postoperative complications and achieve optimal results of radical correction.

Objective: The study aimed to assess the results of staged surgical treatment of critical coarctation of the aorta in newborns in a series of three cases.

Methods: The present research is a prospective one. A series of three cases of staged surgical treatment of newborn children with critical coarctation of the aorta was performed at the Research Institute for Complex Problems of Cardiovascular Diseases in 2024. Due to the severity of the conditions caused by multiple organ failure or the infectious process, the first stage in all cases was stenting of the coarctation of the aorta through the access of the common femoral artery on the right, followed by radical correction within one hospitalization.

Results: All children were full-term and had normal birth weight, but the severity of the condition did not allow performing the initial radical correction of abnormality. Considering the comorbidity, all children underwent stenting of the aortic coarctation as the first stage of correction. Positive dynamics were observed in all 3 cases and included a decrease in the pressure gradient on the isthmus of the aorta, normalization of clinical and paraclinical indicators that allowed performing radical correction in the shortest time possible. Postoperative complications were not observed in all 3 cases, and all children were discharged home in a satisfactory condition after the rehabilitation stage.

Conclusion: The choice of surgical tactics in favor of stenting of critical coarctation of the aorta in newborn children with a severe comorbid background, even with good weight and height indicators, can be the key to salvation, which allows stabilizing the patients and preparing them for subsequent radical correction to achieve the best results.

Received 9 December 2024. Revised 23 December 2024. Accepted 25 December 2024.

Informed consent
The patients’ legal representatives informed consent to use the records for medical purposes is obtained.

Funding
The work was supported by a comprehensive program of basic scientific research of the Russian Academy of Sciences within the framework of the fundamental theme of the Research Institute for Complex Issues of Cardiovascular Diseases No. 0419-2024-0002 “Perioperative neuroprotective strategies in the surgery of congenital heart defects” with financial support from the Ministry of Science and Higher Education of the Russian Federation within the framework of the national project “Science and Universities”. State registration number: 124041800039-2.

Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors
Literature review: A.A. Rumyantseva, R.S. Tarasov, E.O. Grishacheva
Drafting the article: A.A. Rumyantseva
Critical revision of the article: R.S. Tarasov, I.K. Khalivopulo, P.A. Shushpannikov
Surgical treatment: R.S. Tarasov, I.K. Khalivopulo, P.A. Shushpannikov
Final approval of the version to be published: A.A. Rumyantseva, R.S. Tarasov, I.K. Khalivopulo, P.A. Shushpannikov, E.O. Grishacheva

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References

  1. Сойнов И.А., Кулябин Ю.Ю., Горбатых А.В., Войтов А.В., Омельченко А.Ю., Горбатых Ю.Н., Иванцов С.М., Архипов А.Н. Паллиативное стентирование коарктации аорты у новорожденного пациента в критическом состоянии. Патология кровообращения и кардиохирургия. 2019;23(1):78-82. https://doi.org/10.21688/1681-3472-2019-1-78-82 Soynov I.A., Kulyabin Yu.Yu., Gorbatykh A.V., Voytov A.V., Omelchenko A.Yu., Gorbatykh Yu.N., Ivantsov S.M., Arkhipov A.N. Palliative stenting in a newborn with critical coarctation of the aorta. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2019;23(1):78-82. (In Russ.) https://doi.org/10.21688/1681-3472-2019-1-78-82
  2. Kulyabin Y.Y., Gorbatykh Y.N., Soynov I.A., Nichay N.R., Zubritskiy A.V., Bogachev-Prokophiev A.V. Double arterial cannulation in the critical management of neonatal aortic arch obstruction with closed ductus arteriosus. World J Pediatr Congenit Heart Surg. 2019;10(1):105-108. PMID: 30799710. https://doi.org/10.1177/2150135118790944
  3. Рзаева К.А., Сойнов И.А., Горбатых А.В., Кулябин Ю.Ю., Войтов А.В., Иванцов С.М., Горбатых Ю.Н., Богачев-Прокофьев А.В. Критическая коарктация аорты. Возможности диагностики и методов хирургической коррекции коарктации аорты у новорожденных. Патология крово­обращения и кардиохирургия. 2020;24(2):46-62. https://doi.org/10.21688/1681-3472-2020-2-46-62 Rzaeva K.A., Soynov I.A., Gorbatykh A.V., Kulyabin Yu.Yu., Voytov A.V., Ivantsov S.M., Gorbatykh Yu.N., Bogachev-Prokofiev A.V. Critical coarctation of the aorta: diagnostic capabilities and methods of surgical treatment of aortic coarctation in newborns. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2020;24(2):46-62. (In Russ.) https://doi.org/10.21688/1681-3472-2020-2-46-62
  4. Buyens A., Gyselaers W., Coumans A., Al Nasiry S., Willekes C., Boshoff D., Frijns J.-P., Witters I. Difficult prenatal diagnosis: fetal coarctation. Facts Views Vis Obgyn. 2012;4(4):230-236. PMID: 24753914; PMCID: PMC3987479.
  5. Tsang V., Haapanen H., Neijenhuis R. Aortic coarctation/arch hypoplasia repair: how small is too small. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2019;22:10‐13. PMID: 31027557. https://doi.org/10.1053/j.pcsu.2019.02.011
  6. Lehnert A., Villemain O., Gaudin R., Méot M., Raisky O., Bonnet D. Risk factors of mortality and recoarctation after coarctation repair in infancy. Interact Cardiovasc Thorac Surg. 2019;29(3):469‐475. PMID: 31089681. https://doi.org/10.1093/icvts/ivz117
  7. Bugeja J., Cutajar D., Zahra C., Parascandalo R., Grech V., DeGiovanni J.V. Aortic stenting for neonatal coarctation of the aorta — when should this be considered? Images Paediatr Cardiol. 2016;18(3):1-4. PMID: 28405206; PMCID: PMC5270202.
  8. Емельянчик Е.Ю., Кириллова Е.П., Якшанова С.В., Демина Т.Б., Калюжная И.И., Персиянова О.А., Леонтьева М.П., Сакович В.А., Дробот Д.Б., Ваземиллер О.А. Результаты применения препарата простагландина Е1 вазапростана в лечении детей с дуктус-зависимым кровообращением. Сибирское медицинское обозрение. 2013;6(84):68-73. Emelyanchik E.Yu., Kirillova E.P., Yakshanova S.V., Demina T.B., Kalyugnaya I.I., Persianova O.A., Leontyeva M.P., Sacovich V.A., Drobot D.B., Vazemiller O.A. Results of using prostaglandin E1 vazaprostan in the treatment of children with ductus-dependent blood circulation. Sibirskoye meditsinskoye obozreniye = Siberian Medical Review. 2013;6(84):68-73. (In Russ.)
  9. Alhussin W., Verklan M.T. Complications of long-term prostaglandin E1 use in newborns with ductal-dependent critical congenital heart disease. J Perinat Neonatal Nurs. 2016;30(1):73-79. PMID: 26813395. https://doi.org/10.1097/JPN.0000000000000152
  10. Sreeram I., Sreeram N., Bennink G. Palliative stent implantation for coarctation in neonates and young infants. Ann Pediatr Cardiol. 2012;5(2):145‐150. PMID: 23129903; PMCID: PMC3487202. https://doi.org/10.4103/0974-2069.99616
  11. Коарктация аорты: клинические рекомендации – 2023. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/754_1?ysclid=m5uoucuhv1773760690 Coarctation of aorta: clinical recommendations – 2023. (In Russ.) Available from: https://cr.minzdrav.gov.ru/preview-cr/754_1?ysclid=m5uoucuhv1773760690
  12. Shetty Shantharam P., Joynt C., Al Aklabi M. Management of critical coarctation of aorta in a premature neonate with low birth weight. Ann Thorac Surg. 2020;110(3):e225-e226. PMID: 32045584. https://doi.org/10.1016/j.athoracsur.2019.12.057
  13. Нохрин А.В., Комиссаров М.И., Алешин И.Ю., Тризна Е.В., Попова Л.Л., Мурашова О.А., Гвоздь Е.М., Иванов Д.О. Этапная коррекция коарктации аорты у маловесных новорожденных (первый опыт). Вестник хирургии имени И.И. Грекова. 2022;181(6):51-57. https://doi.org/10.24884/0042-4625-2022-181-6-51-57 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
  14. Сойнов И.А., Рзаева К.А., Горбатых Ю.Н., Кулябин Ю.Ю., Горбатых А.В., Велюханов И.А., Ничай Н.Р., Архипов А.Н. Пятнадцатилетний опыт лечения коарктации аорты. Детские болезни сердца и сосудов. 2023;20(2):126-140. https://doi.org/10.24022/1810-0686-2023-20-2-126-140 Soynov I.A., Rzaeva K.A., Gorbatykh Yu.N., Kulya­bin Yu.Yu., Gorbatykh A.V., Velyukhanov I.A., Nichay N.R., Arkhipov A.N. Fifteen years of experience in the treatment of aortic coarctation. Children`s Heart and Vascular Diseases. 2023;20(2):126-140. (In Russ.) https://doi.org/10.24022/1810-0686-2023-20-2-126-140
  15. Рзаева К.А., Сойнов И.А., Горбатых А.В., Архипов А.Н., Горбатых Ю.Н., Богачев-Прокофьев А.В. Оптимальны ли результаты паллиативного стентирования у новорожденных с критической коарктацией аорты? Грудная и сердечно-сосудистая хирургия. 2023;65(3):277-285. https://doi.org/10.24022/0236-2791-2023-65-3-277-285 Rzaeva K.A., Soynov I.A., Gorbatykh A.V., Arkhipov A.N., Gorbatykh Yu.N., Bogachev-Prokophiev A.V. Palliative stenting of aortic coarctation in critically ill newborns. Grudnaya i serdechno-sosudistaya khirurgiya = Russian Journal of Thoracic and Cardiovascular Surgery. 2023;65(3):277-285. (In Russ.) https://doi.org/10.24022/0236-2791-2023-65-3-277-285
  16. Grieshaber P., Merbecks M., Jaschinski C., Fonseca E., Arnold R., Karck M., Gorenflo M., Loukanov T. Surgical treatment following stent angioplasty for high-risk neonates with critical coarctation of the aorta. World J Pediatr Congenit Heart Surg. 2022;13(4):426-435. PMID: 35757941; PMCID: PMC9243453. https://doi.org/10.1177/21501351221099933