Huerta Carlos Theodore, Quinn Kirby, Restrepo Ricardo, Mas Madeleen, Patel Bhavi, Melnick Steven J, Sola Juan E, Velazquez Omaida C, Thorson Chad M
Dewitt-Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Pediatric Specialists of America, Pediatric Interventional Radiology, Nicklaus Children's Hospital, Miami, FL, USA.
J Surg Case Rep. 2023 Apr 22;2023(4):rjad198. doi: 10.1093/jscr/rjad198. eCollection 2023 Apr.
Mycotic aneurysms are exceedingly rare in the pediatric population. The optimal surgical treatment for children with this disease is unclear as aneurysm resection and vascular reconstruction are uncommonly performed in young children. We present a unique case of a 21-month-old child with a complex cardiac history who presented with limb ischemia and was discovered to have thrombosis of the common femoral and superficial femoral artery. Groin exploration revealed a left common femoral and superficial femoral artery mycotic aneurysm that was successfully repaired with excision of the mycotic aneurysm, external iliac to profunda femoral artery vascular bypass using cryopreserved arterial allograft and femoral vein reconstruction. This case demonstrates successful vascular reconstruction can be performed in a young child with an mycotic aneurysm using cadaveric arterial allograft.
真菌性动脉瘤在儿科人群中极为罕见。由于在幼儿中很少进行动脉瘤切除和血管重建,因此对于患有这种疾病的儿童的最佳手术治疗方法尚不清楚。我们报告了一例独特的病例,一名21个月大的儿童有复杂的心脏病史,出现肢体缺血,经检查发现股总动脉和股浅动脉血栓形成。腹股沟探查发现左股总动脉和股浅动脉真菌性动脉瘤,通过切除真菌性动脉瘤、使用冷冻保存的动脉同种异体移植物进行髂外动脉至股深动脉血管旁路移植以及股静脉重建成功修复。该病例表明,使用尸体动脉同种异体移植物可为患有真菌性动脉瘤的幼儿成功进行血管重建。