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Dragomir C, Manea AM, Enatescu VR, Lacatusu AAM, Lacatusu A, Henry OI, Boia M, Ilie C. Left heart hypoplasia operated using double pulmonary arterial banding with double arterial duct stenting: A case report. Exp Ther Med 2020; 20:193. [PMID: 33101483 DOI: 10.3892/etm.2020.9323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/10/2020] [Indexed: 01/21/2023] Open
Abstract
Hypoplastic left heart syndrome is a heterogeneous group of congenital cardiac malformations which associates hypoplastic/aplastic left ventricle, mitral and aortic valve, hypoplastic/atresia and severe aortic artery coarctation, and represents a medical-surgical emergency. We present a case of a newborn hospitalised in three clinics (two clinics from Timisoara and one from Vienna), and operated for hypoplastic left heart syndrome, without aortic coarctation, using a mixed technique cardiovascular repair surgery. The initial therapeutic conduct included maintaining the permeability of the arterial canal with prostaglandin E1. At the Vienna General Hospital, at the age of 17 days, bilateral banding of the pulmonary artery was performed and, at the age of 20 days, during the cardiac catheterisation, the Rashkind procedure (balloon atrial septostomy) was performed, with two stents being implanted in the arterial canal. Postoperative complications were postcardiotomy syndrome, pneumonia with Enterococcus faecalis and Stenotrophomonas maltophilia, sepsis with methicillin-resistant Staphylococcus aureus, coagulopathy, mixed anaemia, and metabolic acidosis. The patient died 1 month after the intervention due to cardiorespiratory arrest, bilateral congestive heart failure, left heart hypoplasia with shunt through the arterial canal and pulmonary artery banding, multiorgan failure, and severe secondary haemorrhagic disease. In conclusion, the initial cardiac surgical reconstruction consisted of a mixed technique, and anticoagulant medical treatment with heparin, antibiotics (bacterial endocarditis prophylaxis to be performed throughout life); postintervention hypoxic and infectious complications resulted in multiorgan failure and death.
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Affiliation(s)
- Cristina Dragomir
- Obstetrics-Gynaecology (XII) Department, Discipline of Neonatology and Childcare, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Aniko-Maria Manea
- Obstetrics-Gynaecology (XII) Department, Discipline of Neonatology and Childcare, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Neonatology-Prematures Department, 'Louis Ţurcanu' Emergency Clinical Hospital for Children, 300011 Timisoara, Romania
| | - Virgil Radu Enatescu
- Neuroscience (VIII) Department, Discipline of Psychiatry, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | - Adrian Lacatusu
- 'Bega' Pediatric II Clinic, 'Pius Brinzeu' County Emergency Clinical Hospital, 300226 Timisoara, Romania.,Pediatrics (XI) Department, Pediatrics II Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Osakwe Ifeanyi Henry
- Pediatric Surgery and Orthopedics Department, Arad County Emergency Clinical Hospital, 310158 Arad, Romania
| | - Marioara Boia
- Obstetrics-Gynaecology (XII) Department, Discipline of Neonatology and Childcare, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Neonatology-Prematures Department, 'Louis Ţurcanu' Emergency Clinical Hospital for Children, 300011 Timisoara, Romania
| | - Constantin Ilie
- Obstetrics-Gynaecology (XII) Department, Discipline of Neonatology and Childcare, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Neonatology Department, 'Pius Brinzeu' County Emergency Clinical Hospital, 300226 Timisoara, Romania
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