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Aneurysm pediatrics

Daniel Verdini, Daniel Vargas, Anderson Kuo, Brian Ghoshhajra, Phillip Kim, Horacio Murillo, Jacobo Kirsch, Michael Lane, Carlos Restrepo
PURPOSE: Coronary-pulmonary arterial fistulas (CPAFs) are rare coronary artery anomalies that have been described only in limited case reports. This study aims to evaluate the clinical presentation and imaging findings of CPAFs collected from 6 participating medical centers along with CPAFs reported in the literature, to discern any general trends present in CPAFs. MATERIALS AND METHODS: A total of 25 cases of CPAF diagnosed by coronary computed tomography angiography were collected across 6 participating institutions...
November 2016: Journal of Thoracic Imaging
M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
Jay Vachhani, Christopher Nickele, Lucas Elijovich, Paul Klimo, Adam S Arthur
Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm. A 12-year-old female presented with new onset seizures and was found to have an incidental distal left anterior cerebral artery aneurysm...
September 29, 2016: World Neurosurgery
Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
September 30, 2016: Journal of Neurosurgery. Pediatrics
P Dueppers, M Duran, K Grabitz, H Schelzig
BACKGROUND: Abdominal aortic aneurysms (AAA) are a very rare in pediatric patients and can rarely be associated with tuberous sclerosis (TS). Open surgery is the first-line-therapy. We report our experience added by a review on current literature. REPORT: A 9-year old boy with TS and history of two earlier open repairs for AAA presented to our department with a recurrent juxtarenal aortic aneurysm. We performed a PTFE patch plasty. Postoperative course was uneventful...
September 22, 2016: Annals of Vascular Surgery
Jennifer Y Lo, L LuAnn Minich, Lloyd Y Tani, Jacob Wilkes, Qian Ding, Shaji C Menon
Management guidelines for refractory Kawasaki disease (KD) are vague. We sought to assess practice variation and identify factors associated with large/complex coronary artery aneurysms (LCAA) and resource utilization in refractory KD. This retrospective cohort study identified patients aged ≤18 years with KD (2004 to 2014) using the Pediatric Health Information System. Refractory KD was defined as receiving >1 dose of intravenous immunoglobulin. Demographics, medications, concomitant infections, length of stay (LOS), and charges were collected...
August 31, 2016: American Journal of Cardiology
A Dionne, M Bakloul, C Manlhiot, B W McCrindle, M Hosking, C Houde, D Pepelassis, N Dahdah
Coronary artery (CA) aneurysms are serious complications of Kawasaki disease (KD) responsible for ischemic events. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are reported with limited data on indications and comparative efficacy. Retrospective multicenter comparison of CA intervention following KD is performed in this study. Twenty two cases were available from 5 centers, of whom 11 underwent CABG, 10 PCI and 1 systemic thrombolysis. Age at intervention (8.3 ± 3.9 vs 11...
September 23, 2016: Pediatric Cardiology
Nobuyasu Kato, Masaaki Yamagishi, Keiichi Kanda, Takako Miyazaki, Yoshinobu Maeda, Masashi Yamanami, Taiji Watanabe, Hitoshi Yaku
PURPOSE: The ideal material for pediatric pulmonary artery (PA) augmentation is autologous pericardium. However, its utility for multistaged operations is limited. In this study, we applied an in vivo tissue-engineered autologous Biotube graft to a patient with congenital heart disease for the first time. DESCRIPTION: For molds of the Biotubes, two silicone 19F drain tubes were embedded in the subcutaneous spaces of a 2-year-old girl with a diagnosis of pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries during palliative surgical procedures...
October 2016: Annals of Thoracic Surgery
Gananjay G Salve, Satish R Javali, Bharat V Dalvi, Shivaprakash Krishnanaik
Aneurysms of ascending aorta are rarely seen in pediatric age group. Only few cases with Marfans syndrome have been reported in the literature. Preferred treatment for these children has been the standard Bentall procedure (aortic root replacement with composite graft prosthesis). We report a 4-year-old male child with huge aneurysm of ascending aorta and aortic root dilation with severe aortic regurgitation, having phenotypic features of Loeys-Dietz syndrome type I. He underwent Bentall procedure with a novel modification (medial trap-door technique for coronary reimplantation)...
September 2016: Annals of Pediatric Cardiology
Yasunari Niimi
Intracranial arteriovenous shunts (ICAVSs) in young children are characterized with frequent high flow fistulas. In association of high flow fistulas and physiological condition of the developing brain and heart, each disease tends to present at a certain age with unique symptoms. Vein of Galen aneurysmal malformation (VGAM) and dural sinus malformation (DSM) with arteriovenous (AV) shunts tend to present in neonate with high output cardiac failure. In infancy, VGAM, pial AVF and infantile dural AVF tend to present with hydrodynamic disorder such as macrocephaly, ventriculomegaly, prominent facial veins, and developmental delay...
September 7, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Audrey Dionne, Léamarie Meloche-Dumas, Laurent Desjardins, Jean Turgeon, Claire Saint-Cyr, Julie Autmizguine, Linda Spigelblatt, Anne Fournier, Nagib Dahdah
BACKGROUND: Diagnosis of Kawasaki Disease (KD) can be challenging in the absence of a confirmatory test or pathognomonic finding, especially when clinical criteria are incomplete. We recently proposed serum NT-proBNP as an adjunctive diagnostic test. METHODS: We retrospectively tested a new algorithm to help KD diagnosis based on NT-proBNP, coronary artery dilation (CAD) at onset, and abnormal serum albumin or C-reactive protein (CRP) levels. The goal was to assess the performance of the algorithm and compare its performance to the 2004 American Heart Association (AHA)/ American Academy of Pediatrics (AAP) algorithm...
September 2, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Ali Seven, Emine Esin Yalinbas, Rahmi Ozdemir
Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease with severe pulmonary insufficiency, characterized with aneurysmal dilation in the pulmonary artery and one or both of its branches. We presented a rare case with APVS and literature review in this letter. Prenatal USG examination of the fetus at the 26th week of gestation revealed severe polyhydramnios, dilatation at right ventricle, and abnormal appearance of the heart. At the 31st gestational week, the baby was born with cesarean section...
2016: Case Reports in Obstetrics and Gynecology
Li-Jun Xue, Rong Wu, Gui-Lian Du, Yan Xu, Kang-Yan Yuan, Zhi-Chun Feng, Yu-Lin Pan, Guang-Yu Hu
Previous studies showed that tumor necrosis factor (TNF) inhibitors might decrease the rate of coronary artery abnormalities in pediatrics with intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD). Therefore, we aimed to evaluate the effect and safety of TNF inhibitors in IVIG-resistant KD. We undertook a meta-analysis of clinical trials identified in systematic searches of PubMed, EMBASE, Cochrane Database, and Google scholar through May 2016. Five studies were included. Overall, rate of coronary artery aneurysm was comparable between groups (relative risk (RR), 1...
August 23, 2016: Clinical Reviews in Allergy & Immunology
Alyaa Al-Ibraheemi, Carrie Y Inwards, Riyam T Zreik, Doris E Wenger, Sarah M Jenkins, Jodi M Carter, Jennifer M Boland, Peter S Rose, Long Jin, Andre M Oliveira, Karen J Fritchie
Although the majority of giant cell tumors (GCTs) of the bone occur in adult patients, occasionally they arise in the pediatric population. In this setting they may be mistaken for tumors more commonly seen in this age group, including osteosarcoma, aneurysmal bone cyst, and chondroblastoma. All cases of primary GCT of the bone arising in patients 18 years and below were retrieved from our institutional archives and examined with emphasis on the evaluation of various morphologic patterns. Clinical/radiologic records were reviewed when available...
August 11, 2016: American Journal of Surgical Pathology
Robert J Beaulieu, Jennifer Lue, Bryan A Ehlert, Joshua C Grimm, Caitlin W Hicks, James H Black
INTRODUCTION: Loeys-Dietz Syndrome (LDS) is characterized by a triad of aortic aneurysm, vessel tortuosity, and hypertelorism. LDS patients often harbor additional aneurysms and dissections throughout their vasculature. The optimal management of these additional lesions is poorly understood. Accordingly, we sought to analyze our experience with the peripheral arterial manifestations of LDS. METHODS: Adult and pediatric LDS patients who sought treatment at a single institution from 2005-2015 were retrospectively reviewed...
August 10, 2016: Annals of Vascular Surgery
Chin Siang Ong, Yuhei Kasai, Souta Fukushima, Narutoshi Hibino, Trent Magruder, Alejandro Suarez-Pierre, Duke Cameron, Luca Vricella
Loeys-Dietz syndrome (LDS) is an autosomal dominant genetic connective tissue disorder associated with aortic aneurysmal disease. Kommerell diverticulum (KD) is a rare aortic diverticulum, for which the indication for surgery and the surgical techniques remain subjects of debate. We describe our experience with a successful total aortic arch replacement including KD resection through a median sternotomy for a pediatric patient with LDS.
September 2016: World Journal for Pediatric & Congenital Heart Surgery
Murat Aydın, Güray Toğral, Fevzi Kekeç, Murat Arıkan, Şafak Güngör
In this article, we report a rarely localized sacral aneurysmal bone cyst (ABC) successfully treated by curettage and bone grafting with fresh frozen fibular allograft (FFA) in a 14-year-old girl patient. The cyst was at S1-2 level and treated with aggressive curettage and bone grafting with two FFAs. All complaints of the patient resolved at the 24th month of treatment and bony union of the cystic cavity was observed radiologically. Curettage and FFA may be safely used for filling the cavity in the treatment of sacral ABC in pediatric age to provide a structural and biological reinforcement...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Kimon Bekelis, Ian D Connolly, Huy M Do, Omar Choudhri
OBJECTIVE The impact of procedural volume on the outcomes of cerebrovascular surgery in children has not been determined. In this study, the authors investigated the association of operative volume on the outcomes of cerebrovascular neurosurgery in pediatric patients. METHODS The authors performed a cohort study of all pediatric patients who underwent a cerebrovascular procedure between 2003 and 2012 and were registered in the Kids' Inpatient Database (KID). To control for confounding, the authors used multivariable regression models, propensity-score conditioning, and mixed-effects analysis to account for clustering at the hospital level...
August 5, 2016: Journal of Neurosurgery. Pediatrics
Hoang H Nguyen, David T Balzer, Joshua J Murphy, Ramzi Nicolas, Shabana Shahanavaz
This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St...
July 25, 2016: Pediatric Cardiology
Jonathan L Eliason, Dawn M Coleman, Enrique Criado, James C Stanley
OBJECTIVE: Pediatric abdominal aortic aneurysms (AAAs) are rare. The intent of this report was to review the presentation and surgical management of AAAs in infancy and early childhood. METHODS: The clinical courses of young children undergoing AAA surgery were subjected to a retrospective review and analysis. RESULTS: Eleven children, nine boys and two girls, ranging in age from 2 weeks to 6 years, underwent surgical treatment of AAA at the University of Michigan from 2002 to 2014...
July 18, 2016: Journal of Vascular Surgery
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