Huge Aortic Aneurysm After Balloon Angioplasty for Coarctation of the Aorta in an Infant

Abstract

A 11-month-old boy was referred to our unit for operation. When he was 20 days old, he had balloon dilatation of the aortic coarctation at another institution. He also had a small ventricular septal defect. During the follow-up, asymptomatic aneurysm formation at the previous coarctation site was determined. On physical examination, there was a systolic mummur at the 4th intercostal space. The echocardiographic examination revealed a small perimembraneous-outlet ventricular septal defect and the aneurysm at the coartation site. Cardiac angiography revealed the giant aneurysm of the descending aorta that was 4.4 cm in diameter (Fig. 1; Clip 1). The surgical approach was made though a left posterolateral thoracotomy. At surgery, the aneurysm (Fig. 2) was incised longitudinally (Fig. 3) and both lateral walls and the anterior wall of the aorta that was involved in the aneurysm were resected. The remainder posterior wall was intact and was not integrated in the aneurysm tissue. Patch aortoplasty was performed with a Hemashield patch (Boston Scientific, Natick, MA). The patch was sutured to the aorta in the standard fashion using a running 5/0 prolene suture (Fig. 4). The postoperative course was uneventful. The patient was discharged on the fourth postoperative day. The patient was well at the 25-month follow-up.