End-to-End Resection for Neonatal Aortic Coarctation with Severe Left Ventricular Dysfunction and Large Ventricular Septal Defect: A Case Report in a 23-Day-Old Infant

Abdulrahman Al Balkhi,1 Abbas Alhelou,1 Sameh Keieaty,1 Abdulrahman Taan,1 Khaled Alhasan,2 Alwaleed Al-Dairy2 1Faculty of Medicine, Damascus University, Damascus, Syria; 2Department of Cardiac Surgery, Faculty of Medicine, Pediatric Cardiac Surgery Unit, Damascus University, Damascus, SyriaCorrespondence: Abdulrahman Al Balkhi, Email [email protected]: Coarctation of the aorta (CoA) may occur alone or in association with other congenital heart defects, including ventricular septal defect (VSD). The coexistence of CoA with a large VSD and decreased left ventricular ejection fraction (LVEF) in neonates is uncommon and presents significant diagnostic and therapeutic challenges. We report the case of a 23-day-old female infant who presented with acute respiratory distress and was found to have CoA, a large membranous VSD, severe pulmonary hypertension, and markedly decreased LVEF. The patient underwent urgent surgical repair consisting of end-to-end CoA resection and pulmonary artery banding. Postoperatively, she demonstrated rapid hemodynamic improvement and recovery of ventricular function. This case highlights the importance of early recognition and timely surgical intervention in neonates presenting with complex CoA physiology and severe ventricular dysfunction.Keywords: coarctation of aorta, ventricular septal defect, low ejection fraction