Deepak Thakur

Fortis Hospital

Title: Neonatal Emergency Cardiac Interventions via Carotid Artery Access for Critical Congenital Heart Disease: A Case Series of 7 Patients

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Biography

Deepak Thakur is a distinguished Pediatric Cardiologist based in Gurugram, India, with over 10 years of experience in managing complex and high-volume cardiac cases. He specializes in fetal cardiology, structural heart interventions, and comprehensive evaluation of congenital heart disease, with expertise in advanced echocardiography techniques including 2D/3D strain imaging, fetal echocardiography, and TEE. His clinical practice also extends to neonatal and adult congenital cardiac care.

He completed his MBBS from Rajiv Gandhi University of Health Sciences, followed by a DNB in Pediatrics from Govt. Multi Specialty Hospital, and an FNB in Pediatric Cardiology from Apollo Hospital. Currently, he serves as Senior Consultant in Pediatric Cardiology at Fortis Hospital, Manesar.

Thakur has published in reputed medical journals, received awards for academic excellence, and actively contributes to teaching and training programs in pediatric echocardiography.

Abstract

Objective: To evaluate the feasibility, safety, and short-term outcomes of emergency percutaneous interventions using carotid artery (CA) access for ductal stenting, coarctation of the aorta (CoA), and critical aortic stenosis (AS) in neonates critical congenital heart disease (CHD), where femoral access was infeasible due to small vessel size or anatomy of duct (Vertical duct from under surface of arch) 

Methods: This retrospective case series reviewed 7 consecutive neonates (gestational age 34-39 weeks; weight 2.1-3.2 kg) presenting in cardiogenic shock and worsening cyanosis from over 1year period Jan-Dec 2025. All underwent urgent Carotid artery access USG guided and fluoroscopy  guidance. Interventions included ductal stenting (n=3), balloon angioplasty/stenting for CoA (n=3), and balloon valvuloplasty for critical AS (n=1). Procedural success was defined as hemodynamic stabilization and bridge to recovery. Follow-up included duplex ultrasound for CA patency.

Results: All procedures were technically successful (100%), with median procedure time 45 min (IQR 38-52) and fluoroscopy 12 min (IQR 10-15). No intraprocedural mortality; one minor stroke like abnormal movement resolved without sequelae. All patients stabilized hemodynamically, with 100% bridging to recovery (median 4 days post-procedure discharge). CA patency was 100% at 30 days.