New Approach for Hybrid Stenting of the Aortic Arch in Low Weight Children

Abstract

We present the first case of hybrid stenting of coarctation of the aorta using a retrograde approach through the descending aorta. An 8-month-old, 5.7 kg infant developed severe obstructive lesion of the aortic arch and isthmus after primary correction of the common arterial trunk and surgical management of coarctation of the aorta. As a result, emergency intervention was needed. Taking into the account the low body weight of the patient and the impossibility of using a transfemoral approach, we decided to obtain access through a 6th intercostal space posterolateral thoracotomy to advance a 6-F guiding catheter to the descending aorta via counter-aperture. After implantation of a Valeo stent, there were no complications, and complete elimination of the obstruction was achieved. This case demonstrates that a retrograde hybrid stenting technique via the descending thoracic aorta for aortic isthmus and arch obstruction produces good anatomical and hemodynamic results and can be applied in cases with no other alternative.