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J Thorac Cardiovasc Surg 2009;137:769-771
© 2009 The American Association for Thoracic Surgery

Brief Communication

A successful neonatal repair of congenital aortic aneurysm with cleft sternum

^a Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY
^b Division of Pediatric Surgery, Columbia University College of Physicians and Surgeons, New York, NY
^c Division of Pathology, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY

Received for publication December 5, 2007; revisions received April 25, 2008; accepted for publication June 21, 2008.

^_* Address for reprints: Yasutaka Hirata, MD, The Division of Pediatric Cardiac Surgery, Columbia University College of Physicians and Surgeons, New York, NY. (Email: yh2240@columbia.edu).

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

Thoracic aortic aneurysm is rare in the pediatric age group; only a few cases have been described and are often associated with connective tissue disorders such as Marfan or Ehlers–Danlos syndrome¹ or coarctation of the aorta.² The association of aortic aneurysm with a sternal defect in infants or children has been previously reported on only 3 occasions.^3-5 Although the long-term morbidity is unknown, 2 of the 3 patients had either progressive dilation⁴ or rupture⁵ of the aneurysm. We report a successful repair of congenital aortic aneurysm and cleft sternum in a neonate.

Clinical Summary

The patient was referred to our hospital with a fetal diagnosis of aortic aneurysm and deficient upper chest wall. She was born by elective cesarean section at 39 weeks of gestation. Upper sternal cleft was noted (Figure 1 ) through which soft tissue would extrude during respiration. Echocardiography and magnetic resonance imaging revealed a significant aortic arch aneurysm with a moderate coarctation located just proximal to the aneurysm (Figure 2, A ).

View larger version (52K):   Figure 1. A, Upper part . . . [Full Text of this Article]