We are a young family of doctors and have a 2.4 years old son who was born with critical isthmic coarctation of aorta, secondary pulmonary hypertension, tricuspidal insuffiency III degree and aortal bicuspidy.
He was operated and the coarctation was corrected in the first 12 days of life in Cluj Napoca at the Cardiovascular Institute through an head-to-head anastomosis.
The post-operatory evolution was very good, and by the 6, 12, 18, 24 months controlls an progressive aortal stenosis was observed.
At this time, the gradient is 110 mm HG at the highest level and at 70 mm Hg at the medium level.
The ejection fractio is 70%. The left ventricle is not dilatated, but with a concentric hypertrophy.
The ascending aorta is constricted at the sino-tubular level.
Pulmonary insufficiency I degree was noted.
The child is very well clinically, the effort capacity is very good, he doesn’t have any sign of illness, and is very smart.
We are proposed now to operate him because of the gradient of the aortal stenosis, who involves the 3 levels, below, middle add upper in the form of a clepsydra but the riscs of needing a pace-maker was told to us is very very big.
Our concerning is about these high risks, and we would like to ask if there are other options or techniques with lower risks in this situation.
For your kindness, thank you
Cristian and Mihaela Chirila, Oradea
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