Axillary artery access for stenting of aortic coarctation in a 1.2 kg premature newborn with malignant systemic hypertension: a case report

Anoosh Esmaeili; Roland Schrewe; Flora Wong; Dietmar Schranz

doi:10.1093/ehjcr/ytaa554

Axillary artery access for stenting of aortic coarctation in a 1.2 kg premature newborn with malignant systemic hypertension: a case report

Eur Heart J Case Rep. 2020 Dec 24;5(2):ytaa554. doi: 10.1093/ehjcr/ytaa554. eCollection 2021 Feb.

Authors

Anoosh Esmaeili¹, Roland Schrewe¹, Flora Wong², Dietmar Schranz¹

Affiliations

¹ Department of Children and Adolescent Medicine, Pediatric cardiology, Frankfurt University Hospital, Frankfurt am Main, Germany.
² Monash Newborn, Children's Hospital, Melbourne, Australia.

Abstract

Background: Axillary artery access is rarely used for demanding percutaneous transcatheter interventions. However, there are many clear advantages.

Case summary: We describe this attractive approach in a 3-week-old premature neonate (bodyweight of 1.2 kg) with severe aortic coarctation. Percutaneous transcatheter intervention was performed with analgo-sedation and local anaesthesia; and a coronary stent was placed with a low fluoroscopy time of 2 min. Malignant systemic hypertension (160/54 mmHg) was effectively treated without any residual blood pressure gradient, with the aim for definitive surgery with stent resection and end-to-end anastomosis at the age of 6-12 months.

Discussion: Axillary artery access is an attractive, alternative approach to treat newborns and premature infants with low body weight with complex heart diseases.

Keywords: Axillary access; Case report; Coarctation; Coarctation stenting; Malignant hypertension; Premature newborn.