Prosthetic graft replacement of a large subclavian aneurysm in a child with Loeys-Dietz syndrome: a case report.

Cardiovascular magnetic resonance imaging Case report Loeys–Dietz syndrome Subclavian artery aneurysm

Journal

European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 03 03 2020
revised: 09 05 2020
accepted: 19 05 2020
entrez: 18 11 2020
pubmed: 19 11 2020
medline: 19 11 2020
Statut: epublish

Résumé

Loeys-Dietz syndrome (LDS) is a genetic connective tissue disorder, which is characterized by rapid development of aortic and peripheral arterial aneurysms. Loeys-Dietz syndrome has some overlapping phenotypic features with other inherited aortopathies such as Marfan syndrome. However, LDS has a more aggressive vascular course with patient morbidity and mortality occurring at an early age. We present the rare case of an 11-year-old girl with LDS who underwent valve sparing aortic root replacement at the age of 2.9 years with good results. She had routine follow-up cardiovascular magnetic resonance imaging and was found to have a large aneurysm of the right subclavian artery. After multidisciplinary team discussion, successful surgical resection with prosthetic graft replacement of the right subclavian artery was performed. This case illustrates that large aneurysms of aortic branches can already develop in childhood and underlines the need for frequent follow-ups including cross-sectional imaging and multidisciplinary team management.

Sections du résumé

BACKGROUND BACKGROUND
Loeys-Dietz syndrome (LDS) is a genetic connective tissue disorder, which is characterized by rapid development of aortic and peripheral arterial aneurysms. Loeys-Dietz syndrome has some overlapping phenotypic features with other inherited aortopathies such as Marfan syndrome. However, LDS has a more aggressive vascular course with patient morbidity and mortality occurring at an early age.
CASE SUMMARY METHODS
We present the rare case of an 11-year-old girl with LDS who underwent valve sparing aortic root replacement at the age of 2.9 years with good results. She had routine follow-up cardiovascular magnetic resonance imaging and was found to have a large aneurysm of the right subclavian artery. After multidisciplinary team discussion, successful surgical resection with prosthetic graft replacement of the right subclavian artery was performed.
DISCUSSION CONCLUSIONS
This case illustrates that large aneurysms of aortic branches can already develop in childhood and underlines the need for frequent follow-ups including cross-sectional imaging and multidisciplinary team management.

Identifiants

pubmed: 33204949
doi: 10.1093/ehjcr/ytaa163
pii: ytaa163
pmc: PMC7649448
doi:

Types de publication

Case Reports

Langues

eng

Pagination

1-4

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

Références

N Engl J Med. 2006 Aug 24;355(8):788-98
pubmed: 16928994
Neurology. 2017 Oct 3;89(14):e174-e175
pubmed: 28972113
Pediatr Radiol. 2009 Sep;39(9):1015
pubmed: 19471917
J Thorac Cardiovasc Surg. 2017 Feb;153(2):406-412
pubmed: 27955909
Nat Genet. 2005 Mar;37(3):275-81
pubmed: 15731757
Ann Thorac Surg. 2015 Apr;99(4):1275-81
pubmed: 25678502
Radiographics. 2018 Jan-Feb;38(1):275-286
pubmed: 29320330
Ann Thorac Surg. 2007 Feb;83(2):S757-63; discussion S785-90
pubmed: 17257922
Ann Thorac Surg. 2014 May;97(5):e125-7
pubmed: 24792298

Auteurs

Mohamed Sobh (M)

Department of Congenital Heart Disease and Paediatric Cardiology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, Kiel, Germany.

Inga Voges (I)

Department of Congenital Heart Disease and Paediatric Cardiology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, Kiel, Germany.

Tim Attmann (T)

Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105 Kiel, Germany.

Jens Scheewe (J)

Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105 Kiel, Germany.

Classifications MeSH