Middle Aortic Syndrome Repair in a 14-Month-Old Child: A 24-Year Case Study.
Mauricio Gonzalez-Urquijo, Francisco Valdes, Jose Francisco Vargas et al.
✦ AI-curated · Sources linked
Case in brief
A 14-month-old boy with severe hypertension and recurrent heart failure was found to have juxta-diaphragmatic aortic coarctation from mid-aortic syndrome. An 8 mm polytetrafluoroethylene thoracoabdominal aorto-aortic bypass resolved his symptoms. At age 14, exercise-induced claudication developed as he outgrew the graft; recanalization of the native aorta with a covered stent restored distal perfusion, and subsequent stent compression was treated with a bare metal stent. At age 24, he was asymptomatic, normotensive, and physically active, with normal ankle-brachial indices and distal perfusion despite occlusion of the original bypass.
What made this case unusual
The long-term course illustrates how growth-related graft limitation and later stent compression were managed by restoring flow through the native aorta, which remained widely patent at age 24 despite occlusion of the original bypass.
Diagnostic / clinical pearl
In a young child with severe hypertension and recurrent heart failure, consider mid-aortic syndrome; after repair, long-term surveillance can identify growth-related graft limitation and endovascular complications.