What is the clinical evidence from this study?

Study design: Observational. Population: Neonates and infants under one year of age with critical congenital heart disease undergoing endovascular correction (n=139). Intervention: Endovascular correction of critical congenital heart defects. Primary outcome: Early perioperative outcomes including hemodynamic stability, complications, ventilatory support requirements, and mortality.

What question did this study set out to answer?

To evaluate anesthesia and critical care approaches during transcatheter interventions in neonates and infants with critical congenital heart defects.

February 24, 2026SHILAP Revista de lepidopterologíaOpen Access

Anesthetic management of endovascular correction of critical congenital heart disease in neonates and infants: a single center study.

Q: What are the key findings of this study?

Endovascular correction in neonates and infants with critical congenital heart disease showed acceptable perioperative stability with 8.5% mortality after balloon aortic valvuloplasty and 0% mortality after balloon angioplasty for coarctation but 46.4% reintervention rate for recoarctation.

Q: What does this research mean for the field?

Endovascular correction in neonates and infants with critical congenital heart disease demonstrates acceptable perioperative stability, with 8.5% mortality after balloon aortic valvuloplasty and 0% mortality but a 46.4% reintervention rate after balloon angioplasty for coarctation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Endovascular correction in neonatal CHD shows acceptable stability despite a ~46% reintervention rate for recoarctation.

n=139

Why the study?

Does individualized anesthetic management provide safe perioperative conditions for endovascular correction of critical congenital heart disease in neonates and infants?

Key Points

To evaluate anesthesia and critical care approaches during transcatheter interventions in neonates and infants with critical congenital heart defects.
Single-center observational cohort study of infants in the first year of life undergoing transcatheter intervention across three cohorts: critical aortic stenosis (n = 47), critical coarctation of the aorta (n = 69), and pulmonary atresia (n = 23).
Anesthetic management consisted of combined sedation using ketamine, local anesthesia, heparin anticoagulation, and multimodal hemodynamic monitoring.
In the aortic stenosis cohort, balloon aortic valvuloplasty decreased transvalvular gradient from 65.2 ± 2.7 mmHg to 30.3 ± 3.0 mmHg (p < 0.05), with early complications occurring in 34.0% of patients and hospital mortality at 8.5%.
In the coarctation cohort, balloon angioplasty reduced systolic gradient to 18.5 ± 6.4 mmHg with 0% mortality, though 46.4% required reintervention for recoarctation.
In the pulmonary atresia cohort, oxygen saturation reached 91.0 ± 5.09% post-dilation, mechanical ventilation was required in 5 patients (lasting 7 hours to 23 days), and inotropic support averaged 8.0 ± 4.7 days.

Study Design

Type

Observational (n=139)

Multicenter

Structured PICO

Does individualized anesthetic management provide safe perioperative conditions for endovascular correction of critical congenital heart disease in neonates and infants?

Population

139 neonates and infants under one year of age diagnosed with critical congenital heart disease undergoing catheter-based endovascular procedures. Cohorts included critical aortic stenosis (n=47), critical coarctation of the aorta (n=69), and pulmonary atresia (n=23).

Intervention

Endovascular correction (including balloon atrial septostomy, balloon valvuloplasty, vascular angioplasty, coarctation dilation, vascular stenting, transcatheter closure) under individualized anesthetic management consisting of intravenous sedation (ketamine-based protocols), local anesthesia with heparin anticoagulation, or general anesthesia with mechanical ventilation.

Outcome

Hemodynamic stability, ventilatory support requirements, intraoperative complications, and early postoperative outcomes.

Individualized anesthetic strategies, including ketamine-based sedation, enable safe and hemodynamically stable transcatheter interventions in neonates and infants with critical congenital heart disease.

Limitations

Single-center observational study without randomization
Heterogeneity of cardiac defects and interventions limited direct comparison between cohorts
No multivariate modeling or risk stratification applied
observational single-center design
lack of multivariate modeling
heterogeneity of cardiac defects and interventions

Discussion

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Implication

Supports individualized ketamine-based anesthesia for stable endovascular correction in neonates; leaves open durability and selection questions for prospective trials.

Cite This Study

Imanov et al. (2026) conducted an observational in Neonates and infants under one year of age with critical congenital heart disease undergoing endovascular correction (n=139). Endovascular correction of critical congenital heart defects was evaluated on Early perioperative outcomes including hemodynamic stability, complications, ventilatory support requirements, and mortality. Endovascular correction in neonates and infants with critical congenital heart disease showed acceptable perioperative stability with 8.5% mortality after balloon aortic valvuloplasty and 0% mortality after balloon angioplasty for coarctation but 46.4% reintervention rate for recoarctation.

synapsesocial.com/papers/699d3fc8de8e28729cf6485e https://doi.org/10.14587/paccj.2026.9

Topics

Congenital heart disease adults

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Implication

Supports individualized ketamine-based anesthesia for stable endovascular correction in neonates; leaves open durability and selection questions for prospective trials.

Anesthetic management of endovascular correction of critical congenital heart disease in neonates and infants: a single center study.

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Anesthetic management of endovascular correction of critical congenital heart disease in neonates and infants: a single center study.

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider