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Cvitkovic T, Petena E, Sarikouch S, Neubert L, Beerbaum P, Horke A, Bobylev D. Idiopathic Aneurysm of the Aortic Arch in an Infant. Thorac Cardiovasc Surg Rep 2022; 11:e54-e57. [PMID: 36134142 PMCID: PMC9484867 DOI: 10.1055/s-0042-1750426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
Congenital aortic aneurysms are rare disorders, usually associated with genetic aortic syndromes. Here, we describe the case of an idiopathic aortic arch aneurysm which had been diagnosed prenatally by fetal echocardiography. The diagnosis was confirmed after birth in the neonatal period and successful surgical resection of the aneurysm was performed at the age of 3 months. The idiopathic etiology of the aneurysm, its localization, and the early surgical resection render this case very unusual.
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Affiliation(s)
- Tomislav Cvitkovic
- Department of Cardiothoracic, Thransplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Elena Petena
- Department of Cardiothoracic, Thransplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Samir Sarikouch
- Department of Cardiothoracic, Thransplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Lavinia Neubert
- Institution of Pathology, Hannover Medical School, Hannover, Germany
| | - Philipp Beerbaum
- Department of Pediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany
| | - Alexander Horke
- Department of Cardiothoracic, Thransplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Dmitry Bobylev
- Department of Cardiothoracic, Thransplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
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2
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Zouizra Z, Benbakh S, Biaou G, Boumzebra D. Ligation of the aorta for a mycotic abdominal aortic aneurysm in an infant. SAGE Open Med Case Rep 2018; 6:2050313X18761309. [PMID: 29511545 PMCID: PMC5833237 DOI: 10.1177/2050313x18761309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 01/30/2018] [Indexed: 11/17/2022] Open
Abstract
Mycotic aortic aneurysms are exceedingly uncommon in infants and they have a high risk of rupture. Their surgical management is extremely challenging. We report a case of a 22-month-old girl who presented with abdominal pain and fever revealing a ruptured mycotic aneurysm of the infrarenal aorta. The surgical treatment consisted of a ligature of the proximal and distal ends of the aneurysm. Postoperative course was significant for hypertension. A year and a half follow-up showed no other complications. Limited data are available concerning our chosen technique, but the reported cases showed a good short-term outcome.
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Affiliation(s)
- Zahira Zouizra
- Cardiovascular Surgery Department, Mohammed VI Teaching Hospital, Marrakech, Morocco
| | - Soukaina Benbakh
- Cardiovascular Surgery Department, Mohammed VI Teaching Hospital, Marrakech, Morocco
| | - Gaël Biaou
- Cardiovascular Surgery Department, Mohammed VI Teaching Hospital, Marrakech, Morocco
| | - Drissi Boumzebra
- Cardiovascular Surgery Department, Mohammed VI Teaching Hospital, Marrakech, Morocco
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3
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Geevarghese B, Fricchione M, Miller D, Benya E, Chadwick EG. Paraspinal Abdominal Mass and Pain in a Toddler Receiving Therapy for Pneumonia. J Pediatric Infect Dis Soc 2016; 5:233-5. [PMID: 26792029 DOI: 10.1093/jpids/piv088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 12/14/2015] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | - Ellen Benya
- Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Illinois
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Venkataraman R, Thangavelu P, Muthukumar S, Jayavelan R, Pyrra D, Karthekeyan BR, Vakamudi M, Rathinasamy J. Novel Cannulation Strategy for Repair of an Ascending Aortic Pseudoaneurysm in a 2.8-kg Infant. Ann Thorac Surg 2015; 100:1453-5. [PMID: 26434445 DOI: 10.1016/j.athoracsur.2014.11.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/14/2014] [Accepted: 11/24/2014] [Indexed: 10/23/2022]
Abstract
Pseudoaneurysm of the ascending aorta is rare in infants, with few cases reported in the literature. These aneurysms are usually mycotic, occurring after cardiac surgery, or caused by mediastinitis. They have high risk of spontaneous rupture. Surgery is usually complex because of the need for peripheral cannulation in small infants. We report an ascending aortic pseudoaneurysm in a less than 3-month-old infant that occurred within a month after repair of type 2 truncus arteriosus and was managed successfully with a modified cardiopulmonary bypass strategy.
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Affiliation(s)
- Rajesh Venkataraman
- Department of Cardiothoracic Surgery, Sri Ramachandra University, Chennai, India.
| | | | | | - Ramkumar Jayavelan
- Department of Cardiothoracic Surgery, Sri Ramachandra University, Chennai, India
| | - Dheeraj Pyrra
- Department of Cardiothoracic Surgery, Sri Ramachandra University, Chennai, India
| | | | - Mahesh Vakamudi
- Department of Anesthesiology, Sri Ramachandra University, Chennai, India
| | - Jebaraj Rathinasamy
- Department of Pediatric Cardiology, Sri Ramachandra University, Chennai, India
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Benrashid E, McCoy CC, Rice HE, Shortell CK, Cox MW. Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report. Ann Vasc Surg 2015; 29:1447.e5-1447.e11. [DOI: 10.1016/j.avsg.2015.06.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 02/08/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
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Borchert E, Lema G, Springmuller D, González K, Chang WT, González R, Garay F. [Successful endovascular treatment of thoracic aortic aneurysm secondary to infection of the umbilical artery catheter in preterm infants]. ACTA ACUST UNITED AC 2015; 86:361-5. [PMID: 26365750 DOI: 10.1016/j.rchipe.2015.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/03/2015] [Accepted: 07/21/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED Aortic aneurysms (AA) in the paediatric population are uncommon. The use of umbilical catheters in neonates has been associated with infections and, on some occasions, the formation of aortic aneurysms. The surgical repair of these aneurysms is one type of treatment; however, percutaneous intervention with stents could provide an alternative treatment route, with fewer complications. The aim of this report is to present the therapeutic scope of a hybrid procedure, in which the combined surgical and percutaneous technique offers a less invasive alternative to open surgery for the repair of aortic aneurysms or their main branches. CLINICAL CASE The case concerns a pre-term newborn of 30 weeks weighing 1,335 g. An umbilical catheter was introduced, which was withdrawn at 14 days due to an infection. It developed as Staphylococcus aureus with sepsis. The echocardiogram and Angio-CT confirmed AA, which were managed using a hybrid procedure of surgery and the endovascular implantation of 2 coated stents (Atrium V12 XR Medical Corp, Hudson, NH). The post-procedure clinical follow-ups, including abdominal echo-tomography, confirmed the success of the treatment. CONCLUSION The endovascular aortic aneurysm repair procedure in premature newborns may be considered when deciding treatment of this disease, and could avoid the risks associated with open surgery. However, follow-up and monitoring is required while the patient grows up, due to the possibility that the implanted stents require re-dilating. The outcomes of neonatal endovascular procedures in the future are unknown.
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Affiliation(s)
- Evelyn Borchert
- División de Anestesiología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile.
| | - Guillermo Lema
- División de Anestesiología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
| | - Daniel Springmuller
- Departamento de Cardiología Pediátrica y Enfermedades Respiratorias, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
| | - Katia González
- División de Anestesiología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
| | - Win T Chang
- División de Anestesiología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
| | - Rodrigo González
- División de Enfermedades Cardiovasculares, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
| | - Francisco Garay
- Departamento de Cardiología Pediátrica y Enfermedades Respiratorias, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Santiago, Santiago, Chile
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Abstract
Ascending aortic aneurysm is uncommon in the paediatric population, and because of the rarity the aetiology, natural progression, and prognosis of the disease remain unknown. A 7-year-old boy with ascending thoracic aortic aneurysm (60×67 mm) underwent graft anastomosis from the sinotubular junction to the undersurface of the arch. Analytical determinations including karyotyping and genetic mapping were all normal. To our knowledge, idiopathic aneurysm of the ascending aorta in children is very rare.
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Yi NJ, Suh KS, Suh SW, Chang YR, Hong G, Yoo T, Kim H, Park MS, Choi YR, Lee KW, Jung CW, Lee JH, Kim YJ, Yoon JH, Lee HS. Excellent Outcome in 238 Consecutive Living Donor Liver Transplantations Using the Right Liver Graft in a Large Volume Single Center. World J Surg 2013; 37:1419-29. [DOI: 10.1007/s00268-013-1976-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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9
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Ferrara SL, Kinney TB, Hall LD. Endovascular treatment of a congenital thoracic aortic aneurysm in a premature newborn. J Vasc Interv Radiol 2012; 23:1330-4. [PMID: 22999752 DOI: 10.1016/j.jvir.2012.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 06/29/2012] [Accepted: 07/02/2012] [Indexed: 11/18/2022] Open
Abstract
Congenital aortic aneurysms are a rare, life-threatening disorder that present complex treatment challenges. The authors describe a congenital thoracic aortic aneurysm treated by endovascular means with stent-assisted coil deployment. Because of rapid in utero aneurysm growth and cardiac dysfunction, a 2.6-kg male was delivered expeditiously by Cesarean section at 35(2)/(7) weeks' gestation. On day of life 1, bilateral femoral arterial access was used to deliver a balloon-expandable stent across the wide-necked aneurysm. Microcoil embolization of the aneurysm via a prepositioned microcatheter was then performed. The child had an uncomplicated hospital course and is asymptomatic 5 months later, with complete aneurysm thrombosis.
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MESH Headings
- Aortic Aneurysm, Thoracic/congenital
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/therapy
- Aortography/methods
- Cesarean Section
- Embolization, Therapeutic
- Endovascular Procedures/instrumentation
- Female
- Gestational Age
- Humans
- Infant, Newborn
- Infant, Premature
- Magnetic Resonance Imaging
- Male
- Pregnancy
- Radiography, Interventional
- Stents
- Tomography, X-Ray Computed
- Treatment Outcome
- Ultrasonography, Doppler, Color
- Ultrasonography, Prenatal/methods
- Young Adult
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Affiliation(s)
- Stephen L Ferrara
- Department of Radiology, Naval Medical Center, San Diego, California, USA.
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Andersen ND, Bhattacharya SD, Williams JB, McCann RL, Hughes GC. Mycotic aneurysm of the thoracoabdominal aorta in a child with end-stage renal disease. J Vasc Surg 2011; 54:1161-3. [PMID: 21723063 DOI: 10.1016/j.jvs.2011.04.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 02/23/2011] [Accepted: 04/23/2011] [Indexed: 10/18/2022]
Abstract
A 5-year-old child with nephrotic syndrome developed a mycotic saccular thoracoabdominal aortic aneurysm (TAAA) involving the visceral segment within a 4-month period following pneumococcal bacteremia and presumed spontaneous bacterial peritonitis (SBP). Due to continued aneurysm growth and progression to end-stage renal disease, TAAA repair was performed, followed by cadaveric kidney transplantation. This is the first known instance of mycotic aortic aneurysm formation as a consequence of SPB and the first report of TAAA repair in preparation for kidney transplantation in a child.
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Affiliation(s)
- Nicholas D Andersen
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
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Yi NJ, Suh KS, Lee HW, Cho EH, Shin WY, Cho JY, Lee KU. An artificial vascular graft is a useful interpositional material for drainage of the right anterior section in living donor liver transplantation. Liver Transpl 2007; 13:1159-67. [PMID: 17663413 DOI: 10.1002/lt.21213] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Congestion in the anterior section in a right liver (RL) without a middle hepatic vein (MHV) may lead to graft dysfunction. To solve this problem, an RL draining MHV branches with autologous or cryopreserved vessels can be introduced. However, these vessels are often unavailable, and their preparation is time-consuming. An expanded polytetrafluoroethylene (ePTFE) graft may be used for anterior section drainage. Between February and November 2005, 26 recipients underwent RL liver transplantation draining MHV branches with an ePTFE graft (group P). Twenty-six ePTFE grafts (6 or 7 mm in internal diameter) drained 35 MHV branches on the back table to the graft right hepatic vein or to the recipient's inferior vena cava. The patency of the ePTFE graft was checked with computed tomography scans of the liver. The outcome of group P was compared with those of an RL group with MHV (group M, n=17) and an RL group without reconstruction of MHV or its tributaries (group R, n=85). The 1-month and 4-month patency rates (PRs) of the ePTFE grafts were 80.8% (21/26) and 38.5% (10/26). All showing early obstruction of the ePTFE graft had congestion in the anterior section, but all showing late obstruction were asymptomatic. The 1-month PRs of group P were comparable to, but the 4-month PRs were lower than, those of group M (both 94.1%; P<0.05). However, 1-year patient and graft survival rates of group P (both 100%) were comparable to those of group M (94.1% and 100%) and better than those of group R (83.5% and 88.2%; P<0.05). In conclusion, the early PR of group P was good, and late obstruction of the ePTFE graft had no impact on congestion in the anterior section or patient survival. Therefore, an ePTFE graft may be a useful interposition material for anterior section drainage in RL transplantation without serious complications.
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Affiliation(s)
- Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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12
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Khandanpour N, Chaudhuri A, Roebuck DJ, Armon MP. Neonatal Mycotic Internal Iliac Aneurysm due to Methicillin-resistant Staphylococcus aureus (MRSA) Septicaemia Successfully Treated by Coil Embolisation. Eur J Vasc Endovasc Surg 2007; 33:687-9. [PMID: 17276103 DOI: 10.1016/j.ejvs.2006.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 12/13/2006] [Indexed: 10/23/2022]
Abstract
A 12-day-old term male neonate presented with septic arthritis, multiple skin and intrabdominal abscesses and a mycotic aneurysm of the right internal iliac artery. He was diagnosed as having methicillin resistant staphylococcus aureus (MRSA) septicaemia and deemed unsuitable for surgical treatment of the aneurysm. Coil embolisation of the internal iliac artery was performed, followed by a successful recovery and with no evidence of residual or recurrent infection. The authors describe a method of treating internal iliac mycotic aneurysms in high-risk patients by endovascular means, which we believe has not been attempted in this precise scenario before.
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Affiliation(s)
- N Khandanpour
- Department of Vascular Surgery, Norfolk & Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK
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