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Aneurysm pediatrics

Thomas Ratschiller, Sames-Dolzer Eva, Wolfgang Schimetta, Patrick Paulus, Hannes Müller, Andreas Zierer, Rudolf Mair
OBJECTIVE: Autograft dilatation is the main long-term complication following the Ross procedure using the freestanding root replacement technique. We reviewed our 25-year experience with the Ross procedure with a special emphasis on valve-sparing reoperations. METHODS: From 1991 to 2016, 153 patients (29.6 ± 16.6 years; 29.4% pediatric) underwent a Ross operation at our institution with implantation of the autograft as freestanding root replacement. The follow-up is 98...
February 20, 2018: Journal of Thoracic and Cardiovascular Surgery
Joyce J Lu, Jason D Slaikeu, Peter Y Wong
Marfan syndrome is a well-described autosomal dominant connective tissue disorder with a constellation of anatomic characteristics including aortic degeneration as a result of the spontaneous mutation of the fibrillin gene, FBN1 . Whereas life-threatening dissection and ascending aneurysmal rupture have been thoroughly documented in the literature, aneurysms of the abdominal aorta and those present in the pediatric population have only rarely been reported. In this case report, we describe presentation, successful open surgical repair, and recovery of a pediatric Marfan syndrome patient with a ruptured abdominal aortic aneurysm...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Dong Joon Kim, Dae Chul Suh, Byung Moon Kim, Dong Ik Kim
Purpose: Adjuvant coils may offer advantages in flow control during glue embolization of high flow vein of Galen aneurysmal malformation (VGAM) patients but involves specific issues such as feasibility, durability and coil mass effect. The purpose of this study is to assess the outcome of adjuvant coils in addition to transarterial glue embolization for treatment of these patients. Materials and Methods: Five pediatric VGAM patients (age range; 11 weeks to 2 yrs 2 mos) with high flow fistulous angioarchitecture were treated with adjuvant coils 1) in the distal feeding artery and/or 2) in the vein of Galen followed by glue embolization of the shunt...
March 2018: Neurointervention
Anil Nanda, Amey R Savardekar, Devi Prasad Patra, Rimal Hanif Dossani, Hugo Cuellar, Maria-Magdelena Georgescu
No abstract text is available yet for this article.
March 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Yeliz Akturk, Serra Ozbal Gunes
NORMAL ABDOMINAL AORTA DIAMETERS IN INFANTS, CHILDREN AND ADOLESCENTS: BACKGROUND: The normal limits of arterial diameters must be known to diagnose pathologies such as dilatation, stenosis and hypoplasia. There are studies which measure the thoracic aorta diameter in childhood, but the number of studies in which the normal aortic diameters are determined is very small. In this study, it was aimed to determine normal standard diameters of aorta and iliac arteries in pediatrics cases, both genders and at different levels...
March 2, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Ravi N Srinivasa, Rajiv N Srinivasa, Sara Zhao, Joseph J Gemmete, Jacob Bundy, Jeffrey F B Chick
Mycotic aneurysms, which may occur anywhere in the body, may be prone to spontaneous rupture. Antibiotic therapy combined with surgical debridement without or with revascularization has been described as potential treatment options. This report describes a combined balloon occlusion technique with the injection of ethylene-vinyl alcohol copolymer for the treatment of a mycotic aneurysm of the pulmonary artery secondary to infective endocarditis. Similar techniques have been described in the cerebral circulation and may obviate concerns for coil erosion, non-target embolization, or superinfection...
February 2018: Radiology Case Reports
Tadahisa Sugiura, Goki Matsumura, Shinka Miyamoto, Hideki Miyachi, Christopher K Breuer, Toshiharu Shinoka
OBJECTIVE: Tissue engineering holds great promise for the advancement of cardiovascular surgery as well as other medical fields. Tissue-engineered vascular grafts have the ability to grow and remodel and could therefore make great advances for pediatric cardiovascular surgery. In 2001, we began a human clinical trial evaluating these grafts in patients with a univentricular physiology. Herein, we report the long-term results of patients who underwent implantation of tissue-engineered vascular grafts as extracardiac total cavopulmonary conduits...
February 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Roberto Blanco Sequeiros, Juha-Jaakko Sinikumpu, Risto Ojala, Jyri Järvinen, Jan Fritz
Minimally invasive procedures play a crucial role in the diagnosis and treatment of many pediatric musculoskeletal conditions. Although computed tomography and fluoroscopy are commonly used for image guidance, the associated exposure to ionizing radiation is especially concerning in pediatric patients. Ultrasonography may be used successfully in a subset of interventions, but it is often not useful for complex, deep, and osseous targets. Interventional magnetic resonance imaging (iMRI) facilitates targeting and treatment of musculoskeletal lesions at many locations with high accuracy due to its excellent tissue contrast...
February 2018: Topics in Magnetic Resonance Imaging: TMRI
Meghan Wilson, Carl Snyderman
Fibro-osseous lesions of the skull base include a variety of lesions with different biologic behavior. The most common lesions include fibrous dysplasia, osteoma, aneurysmal bone cyst, and juvenile ossifying fibroma. The diagnosis can usually be established with radiographic imaging. In the absence of symptoms, slow-growing lesions can often be observed. When surgery is indicated for relief of symptoms, endoscopic endonasal techniques are well suited for all age groups.
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Reiko Kawai, Osamu Nomura, Yutaro Tomobe, Yoshihiko Morikawa, Koichi Miyata, Hiroshi Sakakibara, Masaru Miura
AIM: We examined whether the paediatric assessment triangle (PAT) could predict the severity of Kawasaki disease. METHODS: We enroled patients diagnosed with Kawasaki disease between July 2012 and June 2016 at the emergency department of Tokyo Metropolitan Children's Medical Center in Tokyo, Japan. Triage nurses assigned participants to unstable or stable PAT groups. We compared the incidence of coronary artery aneurysms (CAA), the Kobayashi score, which measures resistance to intravenous immunoglobulin treatment, and the incidence of initial treatment resistance...
January 31, 2018: Acta Paediatrica
Candice D Carpenter, Luke L Linscott, James L Leach, Sudhakar Vadivelu, Todd Abruzzo
BACKGROUND: Alagille syndrome is a pediatric multisystem disease with increased prevalence of cerebrovascular disease. The spectrum of cerebrovascular disease in Alagille syndrome includes cerebral aneurysms, moyamoya arteriopathy and dolichoectasia. The prevalence of cerebrovascular disease in Alagille syndrome varies widely in the literature. OBJECTIVE: To determine the prevalence of cerebrovascular disease in our institution's Alagille patient population by employing a full primary review of all available neuroimaging...
January 23, 2018: Pediatric Radiology
Katsuhiro Mizutani, Tomoru Miwa, Takenori Akiyama, Yoshiaki Sakamoto, Hirokazu Fujiwara, Kazunari Yoshida
PURPOSE: The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. METHODS: We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls...
January 22, 2018: Neuroradiology
Steven B Carr, Greg Imbarrato, Robert E Breeze, C Corbett Wilkinson
The authors present the case of a pediatric patient with Loeys-Dietz syndrome (LDS) who underwent craniotomy for clip ligation of a ruptured intracranial aneurysm. To the authors' knowledge, this is the youngest reported patient with LDS who has been treated for a ruptured intracranial aneurysm. The patient presented with aneurysmal subarachnoid hemorrhage even though the results of surveillance screening were negative, and the aneurysm arose from the wall of the parent artery away from an arterial branch point...
January 19, 2018: Journal of Neurosurgery. Pediatrics
Elias Kfoury, Aaron Y Chen, Peter H Lin
Peripheral arterial aneurysms in children are uncommon. We report a 6-year-old boy who developed a right posterior tibial artery aneurysm with symptoms including pain and pulsatile tenderness. His genetic testing revealed a SMAD3 mutation, a condition associated with familial aortic aneurysm, early-onset of osteoarthritis, and peripheral aneurysms. The posterior tibial artery aneurysm was treated with surgical resection and primary anastomosis. The patient remained free of symptoms or aneurysm recurrence in his tibial artery 2 years later...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Brittany S Mead, Muhammad A Rana, Nathan R Blecker, Julie Riley, Michael S Davis
No abstract text is available yet for this article.
March 2018: Urology Case Reports
Jesus M Matos, Lorena Gonzalez, Elias Kfoury, Angela Echeverria, Carlos F Bechara, Peter H Lin
Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Pertinent clinical variables and treatment outcomes were analyzed. Results Sixty-eight patients underwent a total of 72 thoracic outlet syndrome operations (mean age 15...
January 1, 2018: Vascular
Holly Corbitt, Cheryl Maslen, Siddharth Prakash, Shaine A Morris, Michael Silberbach
In Turner syndrome, the potential to form thoracic aortic aneurysms requires routine patient monitoring. However, the short stature that typically occurs complicates the assessment of severity and risk because the relationship of body size to aortic dimensions is different in Turner syndrome compared to the general population. Three allometric formula have been proposed to adjust aortic dimensions, all employing body surface area: aortic size index, Turner syndrome-specific Z-scores, and Z-scores based on a general pediatric and young adult population...
December 15, 2017: American Journal of Medical Genetics. Part A
Serena Y Tan, Linda J Szymanski, Carlos Galliani, David Parham, Eduardo Zambrano
Pathological diagnosis of solitary fibrous tumor (SFT) in the pediatric population is challenging, as it occurs uncommonly in this age-group and resembles other spindle cell neoplasms. SFT contains a NAB2-STAT6 fusion gene, which can be reliably detected using STAT6 immunohistochemistry. Positive staining is highly sensitive and specific. We sought to investigate the utility of STAT6 immunohistochemistry, to show how commonly SFT was historically recognized at 3 academic pediatric institutions, to reclassify them when appropriate, and to demonstrate features of major mimics of SFT...
January 1, 2017: Pediatric and Developmental Pathology
Jiarong Wang, Zhoupeng Wu, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan
True axillary artery aneurysms in children are rare and mostly caused by blunt trauma. Idiopathic bilateral axillary aneurysms in children are even more infrequent, and evidence for optimal management is scarce. Moreover, the maximum follow-up time of interventions reported in pediatric axillary artery aneurysms was less than 1 year, and long-term outcomes remained unknown. In this report, we presented a 6-year-old child with bilateral axillary artery aneurysms treated by saphenous vein reconstruction with a 5-year follow-up...
December 5, 2017: Annals of Vascular Surgery
Masami Ochi
In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential...
March 2018: General Thoracic and Cardiovascular Surgery
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