Balloon angioplasty for critical coarctation of the aorta in a small infant with depressed cardiac function

We present a case involving a 2-month-old, 3.0 kg female infant who exhibited decompensated heart failure secondary to critical coarctation of the aorta (CoA), accompanied by severely compromised left ventricular systolic function. Given the elevated surgical risk and unfavorable anatomical considerations, balloon angioplasty was performed via ultrasound-guided femoral arterial access. The procedure yielded a substantial reduction in the pressure gradient across the coarctation segment, resulting in considerable clinical improvement and no immediate complications. This case highlights the efficacy of balloon angioplasty as a life-saving intervention for critically ill infants with discrete CoA with impaired cardiac output, particularly in the context of high or prohibitive surgical risk.