Cases reported • Infant, Premature, Diseases

11/17. Caudal blockade in the management of aortic thrombosis following umbilical artery catheterisation.

A neonate, with a postconceptual age of 29 weeks, suffered thrombosis of the aorta as a consequence of umbilical artery catheterisation. This resulted in ischaemic lesions of the lower limbs and buttocks. Part of the management consisted of the insertion of an extradural catheter, via the caudal route, which provided good pain relief and may have improved lower limb blood flow.

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ranking = 1
keywords = aorta
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12/17. Percutaneous balloon aortoplasty of recoarctation: an alternative approach using the axillary artery.

A female infant, presenting with congestive cardiac failure at 6 weeks of age, was found to have severe juxtaductal coarctation of the aorta and multiple ventricular septal defects. She underwent resection of the coarctation with end-to-end anastomosis. Four months postoperatively, she developed severe recoarctation with impalpable femoral pulses. Successful balloon aortoplasty was carried out using a percutaneous approach via the right axillary artery.

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ranking = 1
keywords = aorta
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13/17. nursing interventions. The nurse's role in the care of a 730 g baby treated with prostaglandins for 62 days for a coarctation of the aorta.

As techniques for saving very low birth weight babies improve, there will be a need to maintain babies with cardiac lesions on continuous infusions of prostaglandins until they gain enough weight so that corrective surgery can be performed. An organized approach to overcome the problems of prematurity through primary nursing is essential when caring for the very low birth weight baby with congenital heart disease requiring long-term prostaglandin therapy.

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ranking = 4
keywords = aorta
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14/17. Multiple thromboses in a premature infant associated with maternal phospholipid antibody syndrome.

Phospholipid antibodies (lupus anticoagulant, cardiolipin) are associated with a syndrome of repeated fetal loss. mothers with phospholipid antibodies are currently being treated with either prednisone, aspirin, or heparin to prevent fetal death. We describe a neonate whose mother had cardiolipin antibody and recurrent fetal loss and was treated with prednisone and aspirin. thrombosis was noted in placental fetal vessels. Thromboses developed in the infant's aorta, left renal artery, middle cerebral artery, and superior sagittal sinus. Infants of phospholipid-positive mothers may have vascular thrombosis and should be carefully monitored for signs of thromboembolism.

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ranking = 1
keywords = aorta
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15/17. Left common carotid artery arising from the pulmonary artery in a patient with digeorge syndrome.

A female infant, born at 33 weeks' gestation with tetralogy of fallot, died of severe perinatal asphyxia 6 hours after birth. Necropsy disclosed two associated vascular anomalies: a right aortic arch with a left common carotid artery arising from the pulmonary artery (isolated left common carotid artery) and an aberrant left subclavian artery arising from the descending aorta. Agenesis of the thymus and parathyroid gland was also found, suggesting that the child also had digeorge syndrome. Origin of the left common carotid artery from the pulmonary artery is exceedingly rare. When planning surgical treatment it is important to be aware of the possibility of this anomaly occurring in association with congenital heart disease, particularly in the presence of tetralogy of fallot, right sided aortic arch, or digeorge syndrome.

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ranking = 1
keywords = aorta
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16/17. Coronary fibromuscular dysplasia presenting as sudden infant death.

We report an unusual case of sudden unexpected infant death in a 3-month-old boy who died of acute myocardial infarction. Histopathologic examination showed typical fibromuscular dysplasia (medial fibroplasia) in the left anterior descending coronary artery, with associated thrombus. The thoracic aorta and celiac, superior mesenteric, and renal arteries also revealed mild intimal lesions. In addition to asphyxia at delivery, a viral infection may have provoked these extensive arterial lesions. The significance of coronary arterial lesions in sudden unexpected infant death is discussed.

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ranking = 1
keywords = aorta
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17/17. Successful balloon angioplasty of a coarctation in an infant <500 g.

We describe the first successful balloon angioplasty of a coarctation in a 460-g newborn infant with coarctation of the aorta and heart failure. A coronary angioplasty catheter was positioned across the coarctation via a transumbilical approach. The waist of the balloon disappeared on maximal inflation and there was an increase in blood pressure distal to the coarctation and the clinical status improved. A ductus arteriosus was ligated 4 days after angioplasty.

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ranking = 1
keywords = aorta
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