Stent fracture and embolization: an unusual late complication of neonatal coarctation of aorta stenting with bioresorbable vascular scaffold.

BACKGROUND

Critical neonatal coarctation of the aorta (CoA) may present with cardiogenic shock and severe ventricular dysfunction, rendering immediate surgical repair high risk. In such situations, transcatheter interventions may be used as a temporary stabilizing strategy.

CASE PRESENTATION: A 10-day-old male neonate with critical CoA presented in cardiogenic shock and severe left ventricular dysfunction. Balloon angioplasty resulted in only transient improvement due to elastic recoil, necessitating rescue implantation of a bioresorbable vascular scaffold. This led to rapid haemodynamic stabilization and recovery of ventricular function. Follow-up computed tomography angiography revealed late scaffold fracture with distal embolization to the proximal abdominal aorta. The child remained clinically stable and subsequently underwent successful elective surgical repair.

CONCLUSION

Although bioresorbable vascular scaffolds can provide short-term haemodynamic stabilization in critically ill neonates with CoA, their use is limited by mechanical vulnerability in the neonatal aorta, as illustrated by late scaffold fracture in this case. Their role should therefore be highly selective, with close imaging surveillance and early definitive surgical correction.