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J Thorac Cardiovasc Surg 2007;133:1098-1099
© 2007 The American Association for Thoracic Surgery

Brief Communication

Thoracic aortic aneurysm in a young infant with congenital aortic stenosis

Dante Picarelli, MDa,*, Serrana Antunez, MDa, Christian Kreutzer, MDb, Guillermo Touyá, MDa, Diego Abdala, MDa, Luis Ligüera, MDa, Gabriel Echegaray, MDa

a Division of Cardiac Surgery and Intensive Care Unit, Congenital Cardiac Unit, American Cardiac Center, American Hospital, Montevideo, Uruguay
b Division of Cardiac Surgery, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina.

Received for publication December 9, 2006; accepted for publication December 14, 2006.

* Address for reprints: Dante Picarelli, MD, Unidad de Cardiopatías Congénitas, Centro Cardiológico Americano, Sanatorio Americano, Isabelino Bosch 2469, Montevideo 11600 Uruguay. (Email: picarelli54@hotmail.com).

The first 20% of the full text of this article appears below.

Thoracic aortic aneurysm is uncommon in pediatric patients.1,2Go Its association with congenital valvar aortic stenosis is rarely seen in infants.3Go To the best of our knowledge there have been no prior reports of surgical treatment of an aortic isthmus aneurysm in an infant with critical aortic stenosis.

We report our experience with this uncommon association in a 45-day-old infant who required aneurysmectomy and aortic balloon dilation.

Clinical Summary

Shortly after birth, congestive heart failure developed in a full-term male neonate weighing 3200 g.

Doppler echocardiography revealed a critical valvular aortic stenosis with an adequate aortic annulus and left ventricle and a severely impaired ventricular function. At the level of the aortic isthmus, an "extremely dilated" ductus arteriosus with a bidirectional shunt was described.

On the second day of age, the patient underwent a successful percutaneous balloon valvotomy with a right carotid approach. The peak systolic gradient decreased from 80 to 30 mm Hg, and the ejection fraction was 25%. The aortogram showed no evidence of residual aortic regurgitation but . . . [Full Text of this Article]






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Copyright © 2007 by The American Association for Thoracic Surgery.