Case report on surgical repair of unusual dissection of arterial duct involving main pulmonary artery in a child with vein of Galen malformation

Abstract

BackgroundDissection involving patent arterial duct (PDA) extending to main pulmonary artery (MPA) is an extremely rare condition.Case summaryWe report a case of complex dissection involving PDA extending to MPA, in a child with vein of Galen malformation. This was surgically corrected under deep hypothermic circulatory arrest, and we describe the pathophysiology and surgical rationale in this report.DiscussionManagement of intracardiac lesion in the presence of intracranial arterio-venous malformations such as vein of Galen is very difficult, and employing deep hypothermic circulatory arrest allows one to manage cerebral protection while offering the visualization of intracardiac anatomy more effectively.

Isolated Dissection of the Ductus Arteriosus Associated with Sudden Unexpected Intrauterine Death

“…They are often associated with connective tissue disorders such as Marfan syndrome or Ehlers Danlos syndrome [34]. They can resolve or evolve with fatal complications such as thromboembolic extension into the main pulmonary artery or the aorta, spontaneous rupture, erosion or compression of adjacent structures, and infection [24,25,[41][42][43].…”

A cardiopulmonary bypass strategy to support a patient with vein of Galen malformation

“…The nature of the lesion necessitated surgical intervention under deep hypothermic circulatory arrest (DHCA) at 18°C, which is described in a separate report. 5…”