Diagnosis and Management of Genetic Causes of Middle Aortic Syndrome in Children: A Comprehensive Literature Review

Hypertension in the Neonatal Intensive Care Unit (NICU): A Case of Mid-Aortic Syndrome

A term baby was born with findings of edema, harsh murmur, and hypertension. Pregnancy course was complicated by hydrops fetalis. Upon birth, blood work did not reveal any abnormalities, but an echocardiogram showed patient in high-output heart failure. A computed tomography (CT) chest, abdomen, and pelvis revealed narrowing of aorta in the thoracic region to distal iliac and renal arteries, consistent with mid-aortic syndrome. Mid-aortic syndrome, which results in the narrowing of thoracic or abdominal aorta, is a rare cause of hypertension, especially in newborns. This case elucidates the importance of maintaining a broad differential when encountering an uncommon problem in a newborn.

A rare middle aortic syndrome with celiac trunk, superior mesenteric and bilateral renal artery involvement

Middle aortic syndrome (MAS) is a rare atypical aortic coarctation (AC), often accompanied by refractory renal hypertension, which eventually leads to death from congestive heart failure, stroke or hypertensive encephalopathy. Computed tomography angiography (CTA) has unique advantages in assessing aortic stenosis and splanchnic artery abnormalities. Prompt aortic bypass surgery can relieve symptoms and improve quality of life. In this study, we report a patient with MAS diagnosed by CTA and follow-up after thoracoabdominal aortic bypass grafting.

Computed tomography for aortic assessment in children

Because the aorta is the major vessel of the body, basic knowledge of aortic pathology is essential to the pediatric imager. This review divides aortic pathology into anatomical (e.g., congenital abnormalities) and acquired (e.g., vasculitis, trauma) entities, providing a brief description of pathology, technical considerations in CT acquisition and processing, and some pearls and pitfalls of interpretation. The objective of this paper is to familiarize general pediatric imagers with imaging features of common as well as high-impact aortic pathology on CT and prepare them for acquisition and reporting.