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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Prostaglandin E 2 in a preterm infant with coarctation of the aorta
  1. Bernadette Khodaghalian1,
  2. Nimish V Subhedar2 and
  3. Ashish Chikermane3
  1. 1 Paediatric Cardiology, Alderhey Children’s Hospital, Liverpool, UK
  2. 2 NICU, Liverpool Womens Hospital, Liverpool, UK
  3. 3 Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Bernadette Khodaghalian, bernadettekhodaghalian{at}doctors.org.uk

Abstract

Prostaglandins are widely used in aortic coarctation to maintain ductal patency and preserve systemic perfusion until surgical intervention can be performed. Although the short-term use of prostaglandins to ameliorate aortic narrowing in neonates with a closed ductus has been reported, it has not been described as a longer term therapy in extremely preterm neonates. A 27-week gestation baby weighing 560 g presented at 40 days of age with coarctation and a closed ductus arteriosus. He was successfully treated with a 7-week course of prostaglandin E2 therapy because surgical intervention was not deemed feasible in view of his size. Treatment resulted in a relaxation of the aortic constriction and improvement in aortic blood flow velocity profile, highlighting the value of long-term prostaglandin therapy in this population and supporting the hypothesis that the presence of ductal tissue contributes to the development of juxtaductal aortic constriction in some extremely preterm infants.

  • congenital disorders
  • neonatal and paediatric intensive care

https://doi.org/10.1136/bcr-2019-230910

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    Footnotes

    • Contributors NVS was responsible for conceiving the idea behind the case report. NVS and BK collated the clinical and echocardiographic information. NVS, BK and AC were all jointly involved in writing up the case report and approving the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Parental/guardian consent obtained.