Balloon angioplasty of aortic coarctation in critically ill newborns using axillary artery access

Meliota, Giovanni; Lombardi, M.; Zaza, Pierluigi; Tagliente, Maria Rosaria; Vairo, Ugo

doi:10.4103/apc.apc_2_19

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…5 Meliota et al did not find any long-term complication with axillary access in their long-term follow-up (4 years) of eight patients. 6 Though we did not do axillary cut down, ipsilateral radial artery was palpable immediately after procedure as well as at follow-up in outpatient department. We did not use pre-and post-procedure Doppler as axillary artery was well palpable and there was no visible swelling/haematoma after procedure and ipsilateral radial artery was palpable in each case.…”

Section: Discussionmentioning

confidence: 91%

Axillary arterial access for balloon dilatation of coarctation of aorta in newborns: a case series

et al. 2021

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Balloon dilatation of coarctation of aorta is a standard of care for the patients presenting with severe left ventricular dysfunction. It can be performed through femoral, carotid, and axillary arterial access. Very few case series were available in the literature through axillary arterial access, despite being its advantage as non-end artery and easily palpable in coarctation of aorta. We present our experience with five cases of neonatal coarctation of aorta with severe left ventricular dysfunction where successful balloon dilatation of coarctation of aorta was performed via axillary approach without adverse events.

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Section: Discussionmentioning

confidence: 91%

Axillary arterial access for balloon dilatation of coarctation of aorta in newborns: a case series

et al. 2021

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“…Schranz and Michel-Behnke described a detailed description of the AA access for cardiac interventions in newborns and promote it as an attractive alternative approach especially compared to carotid and femoral access (3). Other authors describe the AA access for BA of the aortic valve or CoA in neonates as a safe but underrepresented access (4,5,10). The AA access can be even easier in patients with CoA and LV failure presenting with decreased perfusion of the femoral artery.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Trans-axillary Artery Access for Rescue Stent Implantation in an Infant With Retrograde Non-passable Aortic Coarctation

et al. 2021

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Primary surgical repair remains the traditional treatment for patients with critical duct-dependent coarctation of the aorta (CoA). Initial surgical repair might not be possible or associated with higher risks if additional comorbidities arise in small infants and neonates. Balloon angioplasty (BA) has been described as a rescue strategy for these children. We describe the feasibility of a palliative BA and rescue stent implantation via an alternative antegrade right-axillary artery approach in an initially inoperable infant with pneumonia and respiratory failure and severe CoA, where the stenosis was not passable by traditional retrograde femoral access. This case adds new aspects to the therapy of critical CoA: Stent implantation provides a bridge to surgery in critically ill infants and does not preclude successful surgical repair. Further, if the classic retrograde approach is not possible, the right axillary artery access should be considered as an alternative to pass the stenosis.

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“…Axillary artery access is a feasible and safe alternative, especially when performed with ultrasound guidance to ensure an isolated anterior wall puncture. An axillary artery is not an end artery and thus, when cannulated, arm perfusion is still guaranteed by the second intercostal and acromial artery [ 23 ]. In the case of a ventricular septal defect, an antegrade femoral or umbilical venous approach may be used for vertical PDAs, but PDA negotiation may still result, which would be cumbersome.…”

Section: Ductus-dependent Pulmonary Blood Flow Chdmentioning

confidence: 99%

“…In selected cases, balloon angioplasty may be performed as a palliative strategy to stabilize neonates unable to undergo urgent surgical treatment due to severe clinical impairment [ 5 , 70 ]. Although the percutaneous treatment of aortic coarctation in neonates and infants remains controversial due to the occurrence of residual or recurrent stenosis and aneurysm formation at the dilation site [ 71 ], urgent balloon dilation can diminish mortality rates, providing a bridge to surgery for severely ill patients [ 23 , 72 ].…”

Section: Aortic Coarctationmentioning

confidence: 99%

Transcatheter Interventions for Neonates with Congenital Heart Disease: A Review

Meliota

Vairo

2023

Diagnostics

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Newborns with congenital heart disease often require interventions linked to high morbidity and mortality rates. In the last few decades, many transcatheter interventions have become the first-line treatments for some critical conditions in the neonatal period. A catheter-based approach provides several advantages in terms of procedural time, length of hospitalization, repeatability and neurodevelopmental issues (usually related to cardiopulmonary bypass). The main transcatheter procedures will be reviewed, as they are now valid alternatives to conventional surgical management.

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Balloon angioplasty of aortic coarctation in critically ill newborns using axillary artery access

Cited by 12 publications

References 13 publications

Axillary arterial access for balloon dilatation of coarctation of aorta in newborns: a case series

Axillary arterial access for balloon dilatation of coarctation of aorta in newborns: a case series

Case Report: Trans-axillary Artery Access for Rescue Stent Implantation in an Infant With Retrograde Non-passable Aortic Coarctation

Transcatheter Interventions for Neonates with Congenital Heart Disease: A Review

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