Endovascular management of complete disruption of aortic anastomosis after pediatric multivisceral transplant

Multivisceral transplantation is a life-saving treatment for many chronically ill patients with advanced abdominal pathologies. For such transplants, a complex arterial reconstruction is required, with numerous anastomoses on a composite donor graft and the native aorta. In these patients, anastomot...

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Published inJournal of vascular surgery cases and innovative techniques Vol. 6; no. 3; pp. 331 - 336
Main Authors McEnaney, Ryan M., Go, Catherine, Li, Xiaoyi, Eslami, Mohammad H.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.09.2020
Elsevier
Subjects
Aortic pseudoaneurysm
Case report
Endovascular
Multivisceral transplant
Stent graft
Aortic pseudoaneurysm
Stent graft
Endovascular
Multivisceral transplant
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Summary:Multivisceral transplantation is a life-saving treatment for many chronically ill patients with advanced abdominal pathologies. For such transplants, a complex arterial reconstruction is required, with numerous anastomoses on a composite donor graft and the native aorta. In these patients, anastomotic disruption or pseudoaneurysm formation, often in the setting of infection, are deadly complications. Open surgical repair is hazardous, because many of these patients have dense adhesions. Reported cases of disruption at the aortic anastomosis to date have resulted in patient demise. We report the case of a pediatric multivisceral transplant recipient with ruptured aortic pseudoaneurysm. He underwent an emergent endovascular parallel stent grafting technique, which successfully controlled bleeding and maintained graft perfusion.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2020.05.004