Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-08T17:37:09.738Z Has data issue: false hasContentIssue false

Percutaneous coarctation dilatation under transthoracic echocardiography guidance solely without fluoroscopy in neonate intensive care

Published online by Cambridge University Press:  17 May 2021

Samir Atmani*
Affiliation:
Medico-chirurgical Pediatric Cardiology Unit, Pediatric’s department, University Hospital Center Hassan II Fez Morocco, Faculty of Medicine of Fez-morocco, University Med Benabdellah
Said Belmkaddem
Affiliation:
Intensive Care Unit, Department of Anesthesia and Reanimation, University Hospital Center Hassan II Fez Morocco, Faculty of Medicine of Fez-morocco, Sidi Mohamed ben Abdellah University, Fez, Morocco
Moustapha Elkouach
Affiliation:
Medico-chirurgical Pediatric Cardiology Unit, Pediatric’s department, University Hospital Center Hassan II Fez Morocco, Faculty of Medicine of Fez-morocco, University Med Benabdellah
*
Author for correspondence: Samir Atmani, Medico-chirurgical Pediatric Cardiology Unit, University Hospital Center Hassan II Fez Morocco, University Med Benabdellah, 145 Jardin El badie route ain Chkaf Fez Morocco 30000. Tel: 00212661350780; Fax: +212 535 619 321. E-mail: [email protected]

Abstract

Introduction:

Neonatal coarctation has to be diagnosed and treated urgently. Actually, the surgical treatment is the main option. The coarctation dilatation is usually achieved under fluoroscopy guidance whenever indicated. Balloon angioplasty could be an alternative approach or transient measure in difficult cases with cardiogenic shock or severe cardiac insufficiency.

In the reported case, we prove and discuss the major role of transthoracic echocardiography, which is used solely to guide the coarctation dilatation in neonate environment.

Objective:

The reported case aims to assess the safety and the efficiency of two-dimensional TEE to guide the dilatation of aortic coarctation in neonate.

Case presentation:

We describe successful dilatation of neonatal coarctation done exclusively using echocardiography in neonatal ICU at the bed. The procedure duration was 40 minutes (from the puncture to sheath removal). The coarctation was diagnosed easily and well described using TTE with good image quality obtained from supra-sternal plane and upper and left lateral view. TayShak balloon measuring 6 and 8 mm were used with a 0.018 French guided exchange wire.

Complete relief of the coarctation was checked by TTE without recording any complication. The follow-up in the third month (the submission time of this manuscript) showed very good results without requiring any surgical intervention or additional restenosis.

Conclusion:

Our initial experience confirmed the safety and efficiency of coarctation dilatation using TTE as the only guidance tool at the bed in neonatal stage, especially in a case presenting severe metabolic and cardiac failure. This report suggests and encourages other potential applications in neonatology intensive care.

Type
Brief Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Johnson, JN, Sathanandam, S, Naik, R, et al. Echocardiographic guidance for transcatheter patent ductus arteriosus closure in extremely low birth weight infants. Congenit Heart Dis 2019; 14: 7478.CrossRefGoogle ScholarPubMed
Rao, PS Neonatal (and Infant) coarctation of the aorta: management challenges. Res Rep Neonatolo 2020; 10: 1122.Google Scholar
Reddington, AN, Booth, P, Shore, DF, Rigby, ML Primary balloon dilatation of coarctation in neonates. Br Heart J 1990; 64: 277281.CrossRefGoogle Scholar
Syamasundar Rao, P, et al. Severe aortic coarctation in infants less than 3 months: successful palliation by balloon angioplasty. J Invasive Cardiol 2003; 15: 202208.Google Scholar
Balcı, KG, et al. Echogenicity and echocardiographic guidance. Anatol J Cardiol 2019; 21: 177178.Google ScholarPubMed