Myocardial calcifications in a neonate with surgically corrected truncus arteriosus: Case report

BackgroundMyocardial calcifications in neonates with truncus arteriosus are rare and poorly understood. These calcifications, resulting from dystrophic processes in injured tissue, may have significant clinical implications. This case highlights a neonate with truncus arteriosus and interrupted aortic arch who developed extensive myocardial calcifications following surgical correction and extracorporeal membrane oxygenation (ECMO).MethodsA neonate with truncus arteriosus underwent surgical repair at 11 days of life, requiring ECMO support. Clinical data, imaging findings, and therapeutic interventions were analyzed to explore the pathophysiology and clinical implications of myocardial calcifications.ResultsThe patient developed recurrent ischemic episodes, significant left ventricular dysfunction, and severe vascular abnormalities. Echocardiography and computed tomography revealed extensive myocardial and extracardiac calcifications. Despite maintaining normal calcium levels, myocardial calcifications were accompanied by progressive heart failure. Surgical attempts to address associated coronary and valvular complications failed to improve outcomes, leading to intractable heart failure and death at 4.5 months of age.ConclusionsThis case underscores the potential role of ischemia-reperfusion injuries, ECMO, and neonatal surgical interventions in the pathogenesis of myocardial calcifications in complex congenital heart disease. These findings highlight the need for further research into preventative and therapeutic strategies for this severe and rare complication.