Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate

Abstract

Primary congenital abdominal aortic aneurysm is an extremely rare entity, with only 15 patients reported in the literature. Options for repair are often limited secondary to branch vessel size and other anatomic limitations. We present a neonate diagnosed with an abdominal aortic aneurysm on prenatal ultrasound. A postpartum computed tomography angiogram revealed an extensive type IV thoracoabdominal aortic aneurysm extending to the aortic bifurcation and resulting in bilateral renal artery stenosis. The unique features of this patient and challenges in management are discussed.

Neonatal Microsurgical Repair of a Congenital Abdominal Aortic Aneurysm with a Cadaveric Graft

“…Aneurysmorrhaphy, repair with native vessels, cryopreserved allografts, and various synthetic grafts have all been utilized to repair congenital AAAs. 24 Prosthetic grafts portend the risk of size mismatch between the graft and native vessel both at the time of surgery and as the child grows, in addition to long-term risks of infection and false aneurysm. 16,25 To decrease the need for reoperation, some have suggested the use of cryopreserved arterial grafts and C-shaped configuration of grafts.…”

Diagnosis and treatment of congenital abdominal aortic aneurysm: a systematic review of reported cases

“…Of the twenty-six cases, six were asymptomatic, and three were discovered during surgical procedures to address other diseases. Other presentations included painless pulsatile abdominal mass in seven cases [ 6 , 10 , 11 , 15 , 16 , 19 , 26 ], emesis in two cases [ 16 , 19 ], respiratory distress in two cases [ 9 , 15 ], failure to pass meconium in one case [ 6 ], paleness and shock in one case [ 17 ], and vomiting and irritability in one case [ 27 ]. Five patients showed concomitant disorders, including Wilms’ tumor [ 6 ], nesidioblastosis [ 11 ], infantile hypertrophic pyloric stenosis [ 16 ], renal dysplasia [ 20 ], and porencephaly [ 25 ].…”

An idiopathic congenital abdominal aortic aneurysm with impending rupture in a 23-month-old boy

“…They are mostly associated with definitive predisposing factors, such as infection, Ehlers-Danlos syndrome, Marfan syndrome, other connective tissue disorders, autoimmune diseases, Kawasaki disease, tuberous sclerosis, trauma, or umbilical artery catheterization. [1][2][3][4][5][6][7][8] An idiopathic congenital AAA is extremely rare. To date, only 16 cases have been reported in the English language literature; most were infrarenal (nine cases [56.3%]), prenatally diagnosed in seven and postnatally in nine.…”

“…Abdominal aortic aneurysms (AAAs) are extremely rare in infants and children, and are mostly associated with congenital cardiac or aortic malformations, systemic diseases, connective tissue disorders, and umbilical artery catheterization in newborns. [1][2][3][4][5][6][7][8] Less common etiologies include infection, vasculitis, autoimmune diseases, and trauma. The least common cause of AAAs is not associated with any definitive predisposing factors.…”