CC BY 4.0 · European J Pediatr Surg Rep. 2021; 09(01): e23-e27
DOI: 10.1055/s-0041-1723019
Case Report

Neonatal Microsurgical Repair of a Congenital Abdominal Aortic Aneurysm with a Cadaveric Graft

Annie Le-Nguyen*
1   Department of Surgery, Division of General Surgery, Saint Justine Hospital, Montreal, Quebec, Canada
,
Shahrzad Joharifard*
2   Department of Surgery, Division of Pediatric Surgery, Saint Justine Hospital, Montreal, Quebec, Canada
,
Geneviève Côté
3   Department of Anesthesiology, Saint Justine Hospital, Montreal, Quebec, Canada
,
Daniel Borsuk
4   Department of Surgery, Division of Plastic Surgery, Saint Justine Hospital, Montreal, Quebec, Canada
,
Rafik Ghali
5   Department of Surgery, Division of Vascular Surgery, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
,
Michel Lallier
2   Department of Surgery, Division of Pediatric Surgery, Saint Justine Hospital, Montreal, Quebec, Canada
› Author Affiliations

Abstract

Congenital abdominal aortic aneurysms (AAA) are an extremely rare entity. We present the case of a female fetus diagnosed with an AAA on routine prenatal ultrasound. A postnatal computed tomography angiogram revealed an infrarenal AAA with a narrow proximal neck. Surgery was performed on day of life 14 using a cadaveric femoral artery graft. The proximal anastomosis was performed under the microscope given the severity of the aortic stenosis and the proximity of the renal arteries. The patient's postoperative course was uneventful and she is developing normally 1 year after surgery. The graft remains permeable, albeit with evidence of proximal and distal stenosis and graft calcification on imaging.

* Both authors contributed equally to the manuscript.




Publication History

Received: 12 May 2020

Accepted: 18 August 2020

Article published online:
03 March 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Sarkar R, Cilley RE, Coran AG. Abdominal aneurysms in childhood: report of a case and review of the literature. Surgery 1991; 109 (02) 143-148
  • 2 Lee BB, Laredo J, Lee TS, Huh S, Neville R. Terminology and classification of congenital vascular malformations. Phlebology 2007; 22 (06) 249-252
  • 3 Howorth Jr MB. Aneurysm of abdominal aorta in the newborn infant. Report of case. N Engl J Med 1967; 276 (20) 1133-1134
  • 4 Mehall JR, Saltzman DA, Chandler JC, Kidd JN, Wells T, Smith SD. Congenital abdominal aortic aneurysm in the infant: case report and review of the literature. J Pediatr Surg 2001; 36 (04) 657-658
  • 5 Kim ES, Caiati JM, Tu J, Nowygrod R, Stolar CJ. Congenital abdominal aortic aneurysm causing renovascular hypertension, cardiomyopathy, and death in a 19-day-old neonate. J Pediatr Surg 2001; 36 (09) 1445-1449
  • 6 Baillie CT, Shankar KR, Grogan R, Lamont GL. Mycotic aortic aneurysm in the newborn. Eur J Pediatr Surg 2000; 10 (02) 148-150
  • 7 Deliège R, Cneude F, Barbier C. et al. [Ruptured mycotic aneurysm with hemoperitoneum: an unusual septic complication of umbilical arterial catheter]. Arch Pediatr 2003; 10 (08) 716-718
  • 8 Millar AJ, Gilbert RD, Brown RA, Immelman EJ, Burkimsher DA, Cywes S. Abdominal aortic aneurysms in children. J Pediatr Surg 1996; 31 (12) 1624-1628
  • 9 Roques X, Choussat A, Bourdeaud'hui A, Laborde N, Baudet E. Aneurysms of the abdominal aorta in the neonate and infant. Ann Vasc Surg 1989; 3 (04) 335-340
  • 10 Luo X, Deng S, Jiang Y. et al. Identification of a Pathogenic TGFBR2 Variant in a Patient With Loeys-Dietz Syndrome. Front Genet 2020; 11: 479
  • 11 Belov S. Classification of congenital vascular defects. Int Angiol 1990; 9 (03) 141-146
  • 12 Mlika S, Limayem F, Monastiri K. et al. [Congenital abdominal infrarenal aortic aneurysm in infants: 2 case reports and literature review]. Tunis Med 2006; 84 (02) 114-117
  • 13 Latter D, Béland MJ, Batten A, Tchervenkov CI, Dobell AR. Congenital abdominal aortic aneurysm. Can J Surg 1989; 32 (02) 135-138
  • 14 Malikov S, Delarue A, Fais PO, Keshelava G. Anatomical repair of a congenital aneurysm of the distal abdominal aorta in a newborn. J Vasc Surg 2009; 50 (05) 1181-1184
  • 15 Bell P, Mantor C, Jacocks MA. Congenital abdominal aortic aneurysm: a case report. J Vasc Surg 2003; 38 (01) 190-193
  • 16 Barral X, de Latour B, Vola M, Lavocat MP, Fichtner C, Favre JP. Surgery of the abdominal aorta and its branches in children: late follow-up. J Vasc Surg 2006; 43 (06) 1138-1144
  • 17 Buddingh KT, Zeebregts CJ, Tilanus ME, Roofthooft MT, Broens PM. Large neonatal thoracoabdominal aneurysm: case report and review of the literature. J Pediatr Surg 2008; 43 (07) 1361-1364
  • 18 Truijers M, Pol JA, Schultzekool LJ, van Sterkenburg SM, Fillinger MF, Blankensteijn JD. Wall stress analysis in small asymptomatic, symptomatic and ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2007; 33 (04) 401-407
  • 19 Biasetti J, Hussain F, Gasser TC. Blood flow and coherent vortices in the normal and aneurysmatic aortas: a fluid dynamical approach to intra-luminal thrombus formation. J R Soc Interface 2011; 8 (63) 1449-1461
  • 20 Kim JI, Lee W, Kim SJ, Seo JW, Chung JW, Park JH. Primary congenital abdominal aortic aneurysm: a case report with perinatal serial follow-up imaging. Pediatr Radiol 2008; 38 (11) 1249-1252
  • 21 Cribari C, Meadors FA, Crawford ES, Coselli JS, Safi HJ, Svensson LG. Thoracoabdominal aortic aneurysm associated with umbilical artery catheterization: case report and review of the literature. J Vasc Surg 1992; 16 (01) 75-86
  • 22 Mendeloff J, Stallion A, Hutton M, Goldstone J. Aortic aneurysm resulting from umbilical artery catheterization: case report, literature review, and management algorithm. J Vasc Surg 2001; 33 (02) 419-424
  • 23 Zuo KJ, Draginov A, Panossian A. et al. Microvascular hepatic artery anastomosis in pediatric living donor liver transplantation: 73 consecutive cases performed by a single surgeon. Plast Reconstr Surg 2018; 142 (06) 1609-1619
  • 24 McAteer J, Ricca R, Johansen KH, Goldin AB. Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate. J Vasc Surg 2012; 55 (06) 1762-1765
  • 25 Khan MS, Moore JW. Treatment of abdominal aortic pseudoaneurysm with covered stents in a pediatric patient. Catheter Cardiovasc Interv 2000; 50 (04) 445-448
  • 26 Kaye AJ, Slemp AE, Chang B, Mattei P, Fairman R, Velazquez OC. Complex vascular reconstruction of abdominal aorta and its branches in the pediatric population. J Pediatr Surg 2008; 43 (06) 1082-1088