Stenting of critical aortic coarctation in newborn: a case series

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.