Palliative stent implantation for aortic coarctation in premature infants weighing

Abstract

Severe aortic coarctation in premature infants with very low birth weight poses specific therapeutic challenges because surgery is associated with increased risk and a higher restenosis rate. 1 Bacha E.A. Almodovar M. Wessel D.L. Zurakowski D. Mayer J.E. Jonas R.A. del Nido P.J. Surgery for coarctation of the aorta in infants weighing less than 2 kg. Ann Thorac Surg. 2001; 71: 1260-1264 Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar Medical palliation with prolonged prostaglandin (PGE) infusion is associated with high output failure, pulmonary overcirculation, and marginal systemic perfusion, resulting in poor weight gain, infections, and excessive delay of surgical repair. 2 Reddy V.M. McElhinney D.B. Sagrado T. Parry A.J. Teitel D.F. Hanley F.L. Results of 102 cases of complete repair of congenital heart defects in patients weighing 700 to 2500 grams. J Thorac Cardiovasc Surg. 1999; 117: 324-331 Abstract Full Text Full Text PDF PubMed Scopus (151) Google Scholar Palliative balloon angioplasty is associated with a very high early restenosis rate, 3 Kothari S.S. Juneja R. Saxena A. Reddy S.C. Sharma S. Balloon dilatation of simple aortic coarctation in neonates and infants. Indian Heart J. 1998; 50: 187-192 PubMed Google Scholar , 4 Rao P.S. Galal O. Smith P.A. Wilson A.D. Five- to nine-year follow-up results of balloon angioplasty of native aortic coarctation in infants and children. J Am Coll Cardiol. 1996; 27: 462-470 Abstract Full Text PDF PubMed Scopus (211) Google Scholar and limited vascular access prohibits the necessary repeat dilations. We describe a novel approach using intravascular stents to palliate severe aortic coarctation in 3 premature infants weighing <1,300 g.