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Comprehensive management of type A acute aortic dissection in the paediatric population with ACTA 2 mutation: case reports and literature review of paediatric aortic dissection

Published online by Cambridge University Press:  04 May 2023

Fumiya Yoneyama Open the ORCID record for Fumiya Yoneyama [Opens in a new window] ,
Ziyad Binsalamah  and
Jeffery S. Heinle
Fumiya Yoneyama*
Affiliation:
Division of Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA
Ziyad Binsalamah
Affiliation:
Division of Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA
Jeffery S. Heinle
Affiliation:
Division of Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA
*
Address for correspondence: Dr F. Yoneyama, MD, PhD, Division of Pediatric Cardiovascular Surgery, Texas Children Hospital, 6651 Main St, Houston, TX 77030, USA. Tel: 832-824-1000; Fax: 832-825-1904. E-mail: fxyoneya@texaschildrens.org
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Abstract

Acute aortic dissection in the paediatric population is rare but lethal. We present two paediatric cases of type A acute aortic dissection that required emergent procedures and were later found to have genetic mutations. High index of suspicion, early clinical diagnosis, prompt treatment, the advantageous collaboration between the paediatric team and aortic surgeons, and familial genetic testing are paramount to achieve a good outcome.

Keywords

Paediatric aortic dissectiongenetic mutationsaortic surgery
Type
Brief Report
Information
Cardiology in the Young , Volume 33 , Issue 11 , November 2023 , pp. 2369 - 2374
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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References

Zalzstein, E, Hamilton, R, Zucker, N, et al. Aortic dissection in children and young adults: diagnosis, patients at risk, and outcomes. Cardiol Young 2003; 13: 341–344.10.1017/S1047951103000696CrossRefGoogle Scholar
Eun, LY, Cho, DK, Cho, YH, Byun, KH. Aortic dissection and rupture in an 11-year-old child: a case report. J Cardiol Cases 2010; 3: e46–49.10.1016/j.jccase.2010.08.001CrossRefGoogle Scholar
Fikar, CR, Fikar, R. Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York state. Clin Cardiol 2009; 32: E23–26.10.1002/clc.20383CrossRefGoogle Scholar
Shamszad, P, Barnes, JN, Morris, SA. Aortic dissection in hospitalized children and young adults: a multiinstitutional study. Congenit Heart Dis 2014; 9: 54–62.10.1111/chd.12090CrossRefGoogle Scholar
Hua, HU, Tashiro, J, Allen, CJ, et al. Hospital survival of aortic dissection in children. J Surg Res 2015; 196: 399–403.10.1016/j.jss.2015.03.030CrossRefGoogle ScholarPubMed
Rathnayake, A, Chang, O, Mejia, R. Acute type-a dissection in a 15-year-old Australian indigenous male - a case report. J Surg Case Rep 2022; 2022: rjac607.10.1093/jscr/rjac607CrossRefGoogle Scholar
Liang, Y, Wan, M, Wang, L, et al. Case report: management of a 10-year-old patient who presented with infective endocarditis and stanford type a aortic dissection. Front Cardiovasc Med 2022; 8: 816213.10.3389/fcvm.2021.816213CrossRefGoogle ScholarPubMed
Xia, J, Cheng, G, He, Y, et al. Imaging appearance of atypical aortic dissection in a 7-year-old boy with loeys-dietz syndrome. J Clin Ultrasound 2022; 50: 1401–1402.10.1002/jcu.23315CrossRefGoogle Scholar
Dueppers, P, Prêtre, R, al, Hofmann Met. Complex multi-stage total aortic and subclavian artery replacement in a 9-year old boy with loeys-dietz-syndrome. Ann Vasc Surg 2022; 80: 396.e1–396.e6.10.1016/j.avsg.2021.10.051CrossRefGoogle Scholar
Matsushita, H, Omiya, H, Uehara, K, et al. Management of an 11-year-old patient who presented with acute aortic dissection. J Cardiol Cases 2021; 24: 72–74.10.1016/j.jccase.2021.01.006CrossRefGoogle ScholarPubMed
Baturone Blanco, A, Martín Conejero, A, Rial Horcajo, R, et al. Aortic rupture by an acute dissection of the thoracoabdominal aorta in a 12-year-old boy. Ann Vasc Surg 2021; 75: 532.e9–532.e13.10.1016/j.avsg.2021.03.025CrossRefGoogle Scholar
Comentale, G, D'Andrea, C, Pilato, E, et al. Type a aortic dissection in an 11-month-old infant with loeys-dietz syndrome. Ann Thorac Surg 2021; 112: e287–e289.10.1016/j.athoracsur.2021.01.045CrossRefGoogle Scholar
Song, L, Jin, J, Ma, X, et al. Aortic dissection and rupture in a 3-year-old boy with bicuspid aortic valve. Eur Heart J 2020; 41: 4363.10.1093/eurheartj/ehaa818CrossRefGoogle Scholar
Mamishi, S, Navaeian, A, Shabanian, R. Acute aortic dissection in a patient with Williams syndrome infected by COVID-19. Cardiol Young 2021; 3: 132–134.10.1017/S1047951120003236CrossRefGoogle Scholar
Kazimierczak, A, Rynio, P, Gutowski, P, et al. Endovascular stenting of a complicated type B aortic dissection in an 11-year-old patient: case report. Medicine (Baltimore) 2018; 97: e0279.10.1097/MD.0000000000010279CrossRefGoogle Scholar
Besli, GE, Durakbasa, CU, Yildirim, S, et al. Acute aortic dissection mimicking acute abdomen in a 14-year-old boy. Pediatr Int 2015; 57: 1169–1171.10.1111/ped.12709CrossRefGoogle ScholarPubMed
Ware, SM, Shikany, A, Landis, BJ, et al. Twins with progressive thoracic aortic aneurysm, recurrent dissection and ACTA2 mutation. Pediatrics 2014; 134: e1218–e1223.10.1542/peds.2013-2503CrossRefGoogle ScholarPubMed
Fitzgerald, KK, Bhat, AM, Conard, K, et al. Novel SMAD3 mutation in a patient with hypoplastic left heart syndrome with significant aortic aneurysm. Case Rep Genet 2014; 2014: 591516.Google Scholar
Stolla, M, Sweeney, A, Alfieris, GM, et al. Aortic aneurysm with a ruptured dissection in a 15-year-old boy with hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 2014; 147: e35–e36.10.1016/j.jtcvs.2013.11.034CrossRefGoogle Scholar
Okawa, H, Yuhara, S, Kozakai, M, et al. [Acute type a aortic dissection operated in childhood; report of a case]. Kyobu Geka 2013; 66: 335–339.Google ScholarPubMed
Onan, B, Güzeltaş, A, Güzeltaş, A, et al. Acute aortic dissection in a 10-year-old boy with bicuspid aortic valve. Anadolu Kardiyol Derg 2012; 12: 695–696.Google Scholar
Vida, VL, Padalino, MA, Motta, R, et al. Traumatic aortic dissection in a boy with Loeys-Dietz syndrome. Ann Thorac Surg 2011; 92: 1520–1522.10.1016/j.athoracsur.2011.03.140CrossRefGoogle Scholar
Herliczek, TW, Brown, LL. An 8-year-old boy with bilateral lower extremity pain and weakness. Pediatr Emerg Care 2011; 27: 872–873.10.1097/PEC.0b013e31822c2896CrossRefGoogle ScholarPubMed
Deml, KF, Schoepf, UJ, Henzler, T. Images in cardiology. Acute aortic dissection in a 9-year-old boy with chest pain. J Am Coll Cardiol 2010; 56: e49.10.1016/j.jacc.2010.04.072CrossRefGoogle Scholar
Konstantinov, IE, Fricke, TA, d'Udekem, Y, et al. Aortic dissection and rupture in adolescents after tetralogy of Fallot repair. J Thorac Cardiovasc Surg 2010; 140: e71–e73.10.1016/j.jtcvs.2010.06.045CrossRefGoogle ScholarPubMed
Uchida, K, Imoto, K, Yanagi, H, et al. Acute aortic dissection occurring during the butterfly stroke in a 12-year-old boy. Interact Cardiovasc Thorac Surg 2009; 9: 366–367.10.1510/icvts.2009.202234CrossRefGoogle Scholar
Heck, JM, Bittles, MA. Traumatic abdominal aortic dissection in a 16-month-old child. Pediatr Radiol 2009; 39: 750–753.10.1007/s00247-009-1224-7CrossRefGoogle Scholar
Civilibal, M, Sever, L, Numan, F, et al. Dissection of the abdominal aorta in a child with Takayasu’s arteritis. Acta Radiol 2008; 49: 101–104.10.1080/02841850701564491CrossRefGoogle Scholar
Osaki, M, Caldarone, CA, Dipchand, AI. Extended aortic dissection following aortic cannulation in an infant. Pediatr Cardiol 2008; 29: 232–233.10.1007/s00246-007-9042-xCrossRefGoogle ScholarPubMed
Yulevich, A, Singer-Jordan, J, Grozovsky, Y, et al. Traumatic abdominal aortic dissection in a child. J Trauma 2007; 62: 1039–1041.Google ScholarPubMed
Hibino, N, Harada, Y, Hiramatsu, T, et al. Intraoperative aortic dissection in pediatric heart sur gery. Asian Cardiovasc Thorac Ann 2006; 14: e55–e57.10.1177/021849230601400329CrossRefGoogle Scholar
Laporte-Turpin, E, Marcoux, MO, Machado, G, et al. Lethal aortic dissection in a 13-year-old boy with a vascular Ehlers-Danlos syndrome. Arch Pediatr 2005; 12: 1112–1115.10.1016/j.arcped.2005.03.043CrossRefGoogle Scholar
Jeganathan, R, Badmanaban, B, Gladstone, D. Spontaneous aortic dissection in a 14-year-old adolescent. J Card Surg 2005; 20: 490–493.10.1111/j.1540-8191.2005.00099.xCrossRefGoogle Scholar
Serdaroğlu, G, Levent, E, Yurtsever, S, et al. Dissection of aorta: a pediatric case report. Turk J Pediatr 2002; 44: 254–257.Google ScholarPubMed
Vogt, BA, Birk, PE, Panzarino, V, et al. Aortic dissection in young patients with chronic hypertension. Am J Kidney Dis 1999; 33: 374–378.10.1016/S0272-6386(99)70315-XCrossRefGoogle ScholarPubMed
Hibino, N, Harada, Y, Hiramatsu, T, et al. Intraoperative aortic dissection in pediatric heart surgery. Asian Cardiovasc Thorac Ann 2006; 14: e55–e57.10.1177/021849230601400329CrossRefGoogle ScholarPubMed
Ota, Y, Tsunemoto, M, Shimada, M, et al. Aortic dissection associated with Turner’s syndrome. Kyobu Geka 1992; 45: 411–414.Google ScholarPubMed
Teien, D, Finley, JP, Murphy, DA, et al. Idiopathic dilatation of the aorta with dissection in a family without Marfan syndrome. Acta Paediatr Scand 1991; 80: 1246–1249.10.1111/j.1651-2227.1991.tb11818.xCrossRefGoogle Scholar
Lawton, JS, Moon, MR, Liu, J, et al. The profound impact of combined severe acidosis and malperfusion on operative mortality in the surgical treatment of type A aortic dissection. J Thorac Cardiovasc Surg. 2018;155:897-904.10.1016/j.jtcvs.2017.11.002CrossRefGoogle ScholarPubMed
Sahu, MK, Ingole, PR, Bisoi, AK, Venugopal, P. Successful management of a case of massive air embolism from cardiopulmonary bypass with retrograde cerebral perfusion in a child. J Cardiothorac Vasc Anesth 2006;20:80-81.10.1053/j.jvca.2005.02.013CrossRefGoogle ScholarPubMed
Yetman, AT, Starr, LJ, Bleyl, SB, et al. Progressive aortic dilation associated with ACTA2 mutations presenting in infancy. Pediatrics. 2015;136:e262-266.10.1542/peds.2014-3032CrossRefGoogle ScholarPubMed