Prostaglandin E 2 in a preterm infant with coarctation of the aorta

• Published in: BMJ case reports Vol. 12; no. 9; p. e230910
• Main Authors: Khodaghalian, Bernadette, Subhedar, Nimish V, Chikermane, Ashish
• Format: Journal Article
• Language: English
• Published: England 18.09.2019
• Subjects: Administration, Intravenous; Aortic Coarctation - diagnostic imaging; Aortic Coarctation - drug therapy; Aortic Coarctation - physiopathology; Blood Flow Velocity - drug effects; Dinoprostone - administration & dosage; Dinoprostone - therapeutic use; Ductus Arteriosus, Patent - diagnostic imaging; Echocardiography; Humans; Infant; Infant, Extremely Premature; Infant, Newborn; Infant, Newborn, Diseases; Male; Oxytocics - administration & dosage; Oxytocics - therapeutic use; Treatment Outcome; neonatal and paediatric intensive care; congenital disorders
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2019-230910

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.