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Is it possible for LPA stenosis to cause pulmonary hypertension in a newborn?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Isaac Gana

Medically reviewed by

iCliniq medical review team

Published At June 3, 2022
Reviewed AtJune 15, 2023

Patient's Query

Hello doctor,

I am writing to get a better understanding of my daughter’s CHD (Congenital heart disease). She was born premature, and she is still on oxygen (1.32 gallons and between twenty-one percent and twenty-five percent). Because of her prematurity, she has BPD (borderline personality disorder), and now I fear that she might have pulmonary hypertension. However, during her stay in the NICU (neonatal intensive care unit), the cardiologist told me that she had an LPA ( left pulmonary artery) stenosis. Still, he said that her oxygen requirement was not related to the pulmonary artery stenosis. Do you think that LPA stenosis can also cause pulmonary hypertension? Or is it purely because of her BPD? Can the LPA stenosis also affect her oxygen requirement? Will she be able to breathe better if they decide to do an angioplasty surgery? What are your thoughts?

Thank you for your expertise, doctor.

Answered by Dr. Isaac Gana

Hi,

Welcome to icliniq.com.

Very sorry to hear about your daughter's illness. Please stay positive. Pulmonary hypertension can be caused by left pulmonary artery stenosis (LPA), but it usually takes time before it progresses. The main cause of her breathing issues is bronchopulmonary dysplasia (BPD), but the LPA worsens the situation. It generally depends on the level of LPA stenosis. I do not understand why they want to do a corrective surgery now. How many months is your baby? What is her general condition? Is she growing significantly concerning her weight?

Best regards.

Patient's Query

Hello doctor,

Thank you for your reply.

They did another echocardiogram two days ago, and they said she has normal pressure, so they ruled out hypertension (for now). They said they would do an angioplasty only if her artery got narrower. Her LPA is not getting any worse now; it is good news. They also said the artery is narrower at the start of the artery, but the size is normal at the end of the artery. I do not understand how it happened because she was not born with an LPA, and from my understanding, an LPA stenosis is a CHD (Congenital heart disease) that occurs in the womb most of the time. However, they told me that this could be due to her PDA ligation surgery (patent ductus arteriosus), so I am not sure what happened, but it looks like something went wrong.

As for her lungs, I do not understand why it is taking so long to see a decrease in her oxygen requirement, but I guess it just takes time because of the severe BPD (bronchopulmonary dysplasia). She is 5 months old now, and she is gaining between 20 to 30 ounces per day, which seems fine. Her percentile is still low compared to other babies her age, but it is quite common with premature babies, I believe.

Answered by Dr. Isaac Gana

Hi,

Welcome back to icliniq.com.

All information points to the fact that there must have been a complication during the patent ductus arteriosus (PDA) ligation surgery. Based on her development, there is a good chance she will pool through. However, it will take time. Being born premature alone will affect her general health condition but does not mean she will not be able to live a normal healthy life in the future. She will need to be on oxygen for a while before any improvement but hopefully will get there.

Regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Isaac Gana
Dr. Isaac Gana

Cardiology

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