Giant aortic aneurysm in a child with Takayasu arteritis

Management of an 11-year-old patient who presented with acute aortic dissection

An 11-year-old boy with no medical or family history was diagnosed with Stanford type B acute aortic dissection. Although a conservative treatment approach was adopted, deep sedation was required to keep him still during computed tomography. It revealed enlargement of the false lumen of the descending aorta, bilateral pleural effusion, and atelectasis. Thus, he underwent descending aortic replacement. After amelioration of perioperative rhabdomyolysis, he was discharged post-recovery. Since there have been no clinical guidelines for management of pediatric aortic dissection, it was difficult to decide between surgical and conservative approaches. Considering difficulty of mild sedation in children, if conservative approaches seem to be problematic, an early surgical approach with aortic replacement is sometimes necessary. <Learning objective: Acute aortic dissection rarely occurs in children or adolescents. There have been no clinical guidelines for management of pediatric aortic dissection. Therefore, it is difficult to decide between surgical and conservative approaches. Considering difficulty of mild sedation in children, if conservative approaches seem to be problematic, an early surgical approach might be effective.>.

Successful Hybrid Zone 0 Landing Thoracic Endovascular Aortic Repair for Ascending Aortic Pseudoaneurysm after Bentall Procedure and Coronary Artery Bypass Grafting in Takayasu Arteritis

Pseudoaneurysm at the suture line is one of the most common complications in aortic surgery for Takayasu arteritis (TA) and is associated with a high mortality rate. A 52-year-old man with TA, who previously underwent the Bentall procedure and 2 redo surgeries for coronary artery obstruction and a pseudoaneurysm of a coronary button, was diagnosed with an anastomotic pseudoaneurysm in the ascending aorta. Hybrid zone 0 debranching thoracic endovascular aortic repair was performed, and the patient was discharged uneventfully on postoperative day 8.

Pediatric Vascular Surgery Review with a 30-Year-Experience in a Tertiary Referral Center

Pediatric vascular disease is rare, and remains a big challenge to vascular surgeons. In contrast to adults, surgery for pediatric vascular disease is complicated by issues related to small size, future growth, and availability of suitable vascular conduit. During the last 30 years, 131 major vascular operations were performed in a tertiary referral center, Seoul National University Hospital, including aortoiliac aneurysm, acute or chronic arterial occlusion, renovascular hypertension, portal venous hypertension, trauma, tumor invasion to major abdominal vessels, and others. Herein we review on the important pediatric vascular diseases and share our clinical experiences on these rare diseases.