A Neonate with Left Congenital Diaphragmatic Hernia and Transient Retrograde Flow in the Aortic Arch

Abstract

Retrograde flow in the aortic arch identifies inadequate cardiac output in neonates with congenital heart disease. We present a left congenital diaphragmatic hernia (CDH) infant with retrograde flow in the arch that normalized after CDH repair. We hypothesize transient inadequacy of the left heart; prostaglandins might play a pivotal role.

Functional Critical Aortic Stenosis with Transient Retrograde Flow in a Neonate with Left Diaphragmatic Hernia

“…Thankavel et al. reported a neonate with left CDH and a retrograde flow in the transverse arch 4 . The right‐to‐left shunt across the PDA directed the blood flow into the transverse arch in a retrograde fashion.…”

“…3 Thankavel et al reported a neonate with left CDH and a retrograde flow in the transverse arch. 4 The right-to-left shunt across the PDA directed the blood flow into the transverse arch in a retrograde fashion. In this case, there was a suspicion of coarctation of aorta with a z-score of aortic isthmus -2.64.…”

“…3 Thankavel et al reported a neonate with left CDH in whom a retrograde flow in the transverse aortic arch was present in the setting of normal LV function. 4 We present a neonate with left CDH with severe LV dysfunction, a retrograde flow in the transverse arch, and minimal antergrade flow across the aortic valve. The hemodynamics in our case resembled critical aortic stenosis.…”