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Aortopulmonary collateral artery in prenatal exposure to carbamazepine - endovascular therapy and technical considerations: a case report.

Pelizzo G, Calcaterra V, Mannarino S, Moramarco LP, Leati G, Quaretti P - J Med Case Rep (2015)

Bottom Line: A good growth gain was obtained.Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms.Management and long-term pediatric multidisciplinary follow-up is recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia, P.le Golgi n.2, 27100, Pavia, Italy. g.pelizzo@smatteo.pv.it.

ABSTRACT

Introduction: Aortopulmonary collateral arteries are an uncommon variant of alternative blood supply in cases of complex congenital heart disease. Although surgery may still be the classic approach for this condition, mini-invasive endovascular occlusion has been recently attempted as an alternative less traumatic procedure. Children born to women with epilepsy are at increased risk of congenital malformations.

Case presentation: A cardiovascular malformation in a 6-year-old white boy with prenatal exposure to carbamazepine is described. At birth, he underwent atrial-ventricular septal defects repair. At 6 years of age, he was diagnosed to have an aberrant aortopulmonary artery from the descending aorta. He presented with recurrent respiratory infections and no cardiovascular signs, but there was associated right upper lobe hyperperfusion. Collateral percutaneous plug embolization was performed because of risk for cardiorespiratory infections, pulmonary hypertension and atrioventricular dilatation. The post-releasing control showed a complete occlusion of the aberrant artery. A chest radiogram and computed tomography showed normalization of vascular pattern of his right lung at 9-months follow-up. No complications and no respiratory infections in the first follow-up year were observed. A good growth gain was obtained.

Conclusions: Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms. Management and long-term pediatric multidisciplinary follow-up is recommended. Prenatal exposure to carbamazepine could be considered in the pathogenesis and diagnosis of the malformation.

No MeSH data available.


Related in: MedlinePlus

Chest radiogram (Panel a) and coronal multiplanar reconstruction (Panel b) of contrast-enhanced multidetector computed tomography showing normalization of the vascular pattern of the right lung (at 9-months follow-up). Vascular plug (arrow)
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Fig5: Chest radiogram (Panel a) and coronal multiplanar reconstruction (Panel b) of contrast-enhanced multidetector computed tomography showing normalization of the vascular pattern of the right lung (at 9-months follow-up). Vascular plug (arrow)

Mentions: A chest radiogram and CT showed normalization of the vascular pattern of the right lung at 9-months follow-up (Fig. 5).Fig. 5


Aortopulmonary collateral artery in prenatal exposure to carbamazepine - endovascular therapy and technical considerations: a case report.

Pelizzo G, Calcaterra V, Mannarino S, Moramarco LP, Leati G, Quaretti P - J Med Case Rep (2015)

Chest radiogram (Panel a) and coronal multiplanar reconstruction (Panel b) of contrast-enhanced multidetector computed tomography showing normalization of the vascular pattern of the right lung (at 9-months follow-up). Vascular plug (arrow)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4551368&req=5

Fig5: Chest radiogram (Panel a) and coronal multiplanar reconstruction (Panel b) of contrast-enhanced multidetector computed tomography showing normalization of the vascular pattern of the right lung (at 9-months follow-up). Vascular plug (arrow)
Mentions: A chest radiogram and CT showed normalization of the vascular pattern of the right lung at 9-months follow-up (Fig. 5).Fig. 5

Bottom Line: A good growth gain was obtained.Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms.Management and long-term pediatric multidisciplinary follow-up is recommended.

View Article: PubMed Central - PubMed

Affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia, P.le Golgi n.2, 27100, Pavia, Italy. g.pelizzo@smatteo.pv.it.

ABSTRACT

Introduction: Aortopulmonary collateral arteries are an uncommon variant of alternative blood supply in cases of complex congenital heart disease. Although surgery may still be the classic approach for this condition, mini-invasive endovascular occlusion has been recently attempted as an alternative less traumatic procedure. Children born to women with epilepsy are at increased risk of congenital malformations.

Case presentation: A cardiovascular malformation in a 6-year-old white boy with prenatal exposure to carbamazepine is described. At birth, he underwent atrial-ventricular septal defects repair. At 6 years of age, he was diagnosed to have an aberrant aortopulmonary artery from the descending aorta. He presented with recurrent respiratory infections and no cardiovascular signs, but there was associated right upper lobe hyperperfusion. Collateral percutaneous plug embolization was performed because of risk for cardiorespiratory infections, pulmonary hypertension and atrioventricular dilatation. The post-releasing control showed a complete occlusion of the aberrant artery. A chest radiogram and computed tomography showed normalization of vascular pattern of his right lung at 9-months follow-up. No complications and no respiratory infections in the first follow-up year were observed. A good growth gain was obtained.

Conclusions: Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms. Management and long-term pediatric multidisciplinary follow-up is recommended. Prenatal exposure to carbamazepine could be considered in the pathogenesis and diagnosis of the malformation.

No MeSH data available.


Related in: MedlinePlus