Supraceliac aortic pseudoaneurysms after liver transplantation in infants.
BACKGROUND
Reconstruction of the hepatic artery in infants undergoing liver transplantation presents challenging vascular situations. Microvascular techniques ensure arterial blood flow via small caliber vessels but are insufficient when inflow is poor. In these situations, the use of allogeneic grafts to the supraceliac aorta have been advocated. The development of a pseudoaneurysm at the supraceliac aortic suture line requires urgent repair and restoration of arterial flow to the graft.


METHODS
Our study was based on case reports and review of the literature.


RESULTS
Definitive diagnosis and successful repair of supraceliac pseudoaneurysm was accomplished in two infants after transplantation.


CONCLUSIONS
We advocate a thoracoabdominal retroperitoneal approach, which provides safe control of the aorta and primary repair or patching of the diseased aortic segment, and also provides access for hepatic revascularization via placement of an infrarenal graft. Thrombosis of the artery and subsequent liver necrosis are indications for retransplantation.
Marcucci
L
L
Department of Surgery, University of Pennsylvania, Philadelphia 19104, USA.
Shaked
A
A
Maller
E S
ES
Rand
E B
EB
Hahn
E S
ES
Higuchi
N H
NH
Barker
C F
CF
Olthoff
K M
KM
D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001656:Biliary Atresia / Q000601:surgery; D005260:Female; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome