# Cardiopulmonary Management for Severe Aortic Valve Stenosis With Noninvasive Ventilation Using a Nasopharyngeal Tube

## TL;DR

A nasopharyngeal tube helped manage a neonate with severe heart valve issues by supporting breathing and circulation without surgery.

## Contribution

The study demonstrates the effectiveness of using a nasopharyngeal tube for noninvasive ventilation in neonates with severe aortic valve stenosis.

## Key findings

- The nasopharyngeal tube allowed stable respiratory and circulatory management post-extubation.
- The patient was successfully weaned off noninvasive ventilation and transferred to the general ward.
- This approach may reduce mechanical ventilation duration and improve postoperative care in severe heart failure.

## Abstract

The nasopharyngeal tube (NT) is an effective interface for noninvasive ventilation (NIV). In cases of severe heart failure, assistance with noninvasive positive-pressure ventilation (NPPV) effectively reduces afterload and alleviates respiratory effort. We present the case of a three-day-old male neonate diagnosed with severe aortic valve stenosis (AS). In respiratory management, extubation was delayed due to increased respiratory effort and afterload, so this patient was extubated and managed with NPPV using an NT. An uncuffed endotracheal tube was inserted, initiating NIV with a positive end-expiratory pressure of 8 cmH2O. The patient exhibited stable vital signs post-extubation and was weaned off NPPV and transferred to the general ward. In this case of severe AS, the use of NT as an interface for NPPV demonstrated efficacy in respiratory and circulatory management. This approach could have shortened the duration of mechanical ventilation and facilitated safe postoperative care, highlighting the potential benefits of NT in managing severe heart failure.