Stephanie Paz-Ramírez, Departamento de Pediatría, Universidad Libre; Grupo de Investigación en Pediatría (GRINPED); Cali, Colombia
Mónica A. Gil-Artunduaga, Departamento de Pediatría, Universidad Libre; Grupo de Investigación en Pediatría (GRINPED); Cali, Colombia
Alfonso M. Valencia-Caicedo, Departamento de Pediatría, Universidad Libre; Grupo de Investigación en Pediatría (GRINPED); Cali, Colombia
José F. Gómez-Urrego, Departamento de Pediatría, Universidad Libre; Grupo de Investigación en Pediatría (GRINPED); Cali, Colombia
Ernesto L. Vallejo-Mondragón, Departamento de Pediatría, Universidad Libre; Departamento de Cardiología, Clínica Imbanaco; Departamento de Hemodinamia Pediátrica, Clínica Imbanaco. Cali, Colombia
Introduction: Coarctation of the aorta is a congenital heart disease, and its treatment varies depending on the age at diagnosis and associated conditions. Timely intervention is crucial to prevent complications such as heart failure and premature death. Objectives: To describe the clinical characteristics and evaluate the outcomes of different management strategies in patients under six months of age with aortic coarctation. Methods: A total of 59 medical records of patients under six months of age with coarctation of the aorta, treated between 2014 and 2024, were reviewed. Data were collected on demographic characteristics, symptoms, complications, pharmacological and surgical treatment, and the presence of recoarctation. Results: 95% of patients were diagnosed before three months of age; 50.8% were male. Altogether, 88.1% of the patients had a systolic ejection murmur. The main clinical manifestation was respiratory distress (59.3%). Cardiogenic shock and respiratory failure occurred in 98.3% of patients. The most common associated anomaly was aortic arch hypoplasia (81.3%). Open surgery was the main treatment (78%), with only one case of recoarctation and one death. Balloon angioplasty without stenting was performed in 10 cases, with recoarctation occurring in 30%. A 30-week preterm infant received a bioresorbable stent, with subsequent recoarctation. Conclusions: Screening for differential cyanosis before hospital discharge is key for diagnosis. Any infant with a systolic ejection murmur should undergo an echocardiogram, as it is the most frequent clinical sign of coarctation. Catheterization is a safe treatment alternative for low-weight patients. Open surgery had a low rate of recoarctation in those who were followed up.
Keywords: Aortic coarctation. Congenital heart disease. Cardiac catheterization. Infant.
