Question

Discuss management and long term follow-up of:
An infant with coarctation of aorta. [4]

Hint:

Early surgical intervention significantly improves outcomes in infants with coarctation of the aorta.

Answer 1

Step 1: Initial Management of Coarctation in an Infant:
1. Prostaglandin E1 (PGE1): Initially, PGE1 is administered to keep the ductus arteriosus patent and improve systemic blood flow.
2. Surgical Intervention: Early surgical correction is necessary for infants, as coarctation can cause significant cardiovascular strain and failure. The surgery typically involves resection of the narrowed section and end-to-end anastomosis.
3. Balloon Angioplasty: In some cases, balloon angioplasty can be used as a less invasive treatment, though it may not be a permanent solution in all infants.
Step 2: Long-Term Follow-Up:
1. Blood Pressure Monitoring: After surgery, regular blood pressure monitoring is essential as some infants may develop hypertension due to residual stenosis or collateral vessels.
2. Cardiac Monitoring: Periodic echocardiograms and follow-up visits are crucial to assess the function of the heart and check for any complications such as re-coarctation.
3. Growth and Developmental Assessments: Monitoring the child's growth and overall development is important as coarctation may impact early development.