Accidental Balloon Dilatation of Patent Ductus Arteriosus in A Case of Critical Coarctation of Aorta: Subsequently A New Innovation for Patent Ductus Arteriosus Dependent Circulation

Abstract

Coarctation of the aorta is a rare form of congenital heart disease, though preductal co-arctation is not very uncommon. This is a report on a 28-days-old girl who was referred to our center for evaluation. Doppler echocardiography showed severe preductalcoarctation of aorta and a tiny Patent DuctusArteriosus (PDA). Later it was confirmed by aortogram which showed critical coarctation of aorta (COA). This full-term infant with symptomatic COA was treated successfully with a Balloon angioplasty procedure. But during last inflation, wire entered through PDA to the pulmonary artery and was dilated with 8×3 Tyshak mini balloon considering balloon placement in Coarctation segment. Aortogram showed a large PDA after balloon dilatation. Immediately patient developed some features of heart failure. Patient was referred to cardiac surgeon as device closure was not possible in such a large PDA in a tiny newborn with maximum size Piccolo device. Subsequently balloon dilatation of PDA was found effective in maintaining circulation to pulmonary tree in PDA dependent cases. Chest Heart J. 2023; 47(2) : 141-145