Critical coarctation of the aorta: diagnostic capabilities and methods of surgical treatment of aortic coarctation in newborns

Critical coarctation of the aorta in newborns usually presents with severe narrowing of the cavotricuspid isthmus and space adjacent to the arterial duct, limiting blood flow to the thoracic aorta. Patient survival depends on duct patency. Rapid deterioration and development of multiple organ failure usually result from spontaneous closure of the patent arterial duct. This deterioration is due in part to reduced renal perfusion and results in fluid and acid retention, causing heart failure and metabolic acidosis. This may be alleviated by the administration of intravenous prostaglandin E1, with a temporary improvement in distal aortic blood flow and the overall condition of the patient. Primary repair is associated with a high risk of unfavourable outcomes due to severe systemic outflow obstruction and multiple organ failure. Therefore, as a bridge to subsequent radical surgery, palliative stenting is the preferred method in newborns with critical aortic coarctation in the decompensated state.