Clipping of an Aortopulmonary Window in a Small Neonate With Bronchial Bleeding: A Simple Solution for a Complex Condition.
Thomas MartensKristof VandekerckhoveWim DecaluweKatrien FrançoisThierry BovePublished in: World journal for pediatric & congenital heart surgery (2022)
Although the conventional treatment of aortopulmonary (AP) window consists of reconstructive surgery with the use of cardiopulmonary bypass (CPB), some conditions like low birth weight or active respiratory tract bleeding may lead to diverting therapeutic options. We present a case of a premature 1.9 kg neonate with severe pulmonary arterial hypertension based on the association of an AP window and large patent ductus arteriosus. Because of intrabronchial hemorrhage, a conservative strategy was chosen excluding the need for heparinization and CPB. Through median sternotomy, the ductus arteriosus and AP window were clipped, effectively occluding both shunts. The postoperative course was uneventful with a rapid decrease of pulmonary artery pressure. Although classical surgical reconstruction is still advocated as primary therapy, this case illustrates the suitability of an alternative approach without the need for CPB and full heparinization in a patient with an increased risk of bleeding complications.
Keyphrases
- pulmonary arterial hypertension
- pulmonary artery
- low birth weight
- pulmonary hypertension
- respiratory tract
- coronary artery
- transcription factor
- atrial fibrillation
- preterm infants
- preterm birth
- human milk
- minimally invasive
- patients undergoing
- coronary artery bypass
- case report
- coronary artery disease
- risk factors
- early onset
- mesenchymal stem cells
- combination therapy
- left ventricular