Mycotic aneurysm of the descending thoracic aorta in a 2-kg neonate.
Umbilical artery catheterization is often performed in critically ill neonates. Infection and thromboembolic events are relatively frequent complications, but aneurysm formation is rare. We describe the case of a premature baby who developed a rapidly expanding aneurysm of the descending thoracic aorta, secondary to a highly placed infected umbilical catheter. The rapid progression under medical therapy prompted us to replace the thoracic aorta with an 8-mm polytetrafluoroethylene graft, using extracorporeal circulation and core cooling. The baby had an excellent recovery and was discharged home after a prolonged antibiotic course. He is being followed with repeated imaging studies for a small abdominal aneurysm. We describe a novel approach to this rare and complicated problem and provide a review of the literature on the subject.
Roy
Nathalie
N
Division of Pediatric Cardiothoracic Surgery, Children's Hospital, University of California, San Francisco, California, USA.
Azakiea
Anthony
A
Moon-Grady
Anita J
AJ
Blurton
Dominic J
DJ
Karl
Tom R
TR
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D014469:Umbilical Arteries
D000900:Anti-Bacterial Agents