Cor Vasa 2024, 66(5):495-499 | DOI: 10.33678/cor.2024.067

Extremity Ischemia after Peripheral Vascular Intervention in Newborns with Congenital Heart Disease: Our Single Center Experience

Kenan Abdurrahman Kara, Ergin Arslanoğlu, Fatih Yiğit, Eylem Tunçer, Nihat Çine, Hakan Ceyran

Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Kartal, Istanbul, Turkey

Background: Acute limb ischemia (ALI) is a rare but serious condition that can cause significant lifetime morbidity or mortality in the pediatric population. It is usually post-traumatic or iatrogenic.

Results: In the study, 127 newborns who were followed up with arterial monitoring in our intensive care unit between 2019-2021 were screened retrospectively. Invasive arterial monitoring was performed on the upper extremities in 83 patients and the lower extremities in 44 patients. Acute extremity ischemia was observed in three (6%) patients who underwent lower extremity monitoring and eight (9%) patients with upper extremity ischemia. Primarily, extremity warming, heparin infusion (10 µ/kg/h), perliganit (Glycerol Trinitrate) infusion (0.5 µg/kg/h) were applied to the patients. Vasoconstrictor agents (adrenaline, noradrenaline etc.) have been avoided in patients whenever possible. All of the patients responded to medical and conservative treatment, and no surgical treatment was applied. Amputation was not applied to any of the patients, and their limb circulations were gradually restored.

Conclusions: Early and correct intervention can significantly reduce mortality and morbidity in ALI, which is rare in the newborn group. Management strategies are still evolving and experience is limited. Although the surgical approach seems to be more prominent in adult patients, positive results can be obtained in newborn acute limb ischemia with close clinical follow-up and medical approach due to technical difficulties and different underlying pathophysiology in the pediatric population.

Keywords: Acute limb ischemia, Iatrogenic arterial trauma, Pediatric arterial access

Received: January 26, 2024; Revised: January 27, 2024; Accepted: September 9, 2024; Prepublished online: June 2, 2012; Published: October 25, 2024  Show citation