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Staged reconstruction for middle aortic syndrome.

C W Lillehei¹, R C Shamberger

¹Children's Hospital, and Harvard Medical School, Boston, MA 02115, USA.

Journal of Pediatric Surgery

|August 2, 2001

Summary

A staged vascular repair effectively treats middle aortic syndrome in children, preserving kidney function and utilizing native arteries. This approach minimizes risks associated with renal ischemia during complex aortic reconstruction.

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Area of Science:

Vascular Surgery
Pediatric Cardiology
Interventional Radiology

Background:

Middle aortic syndrome is a rare pediatric condition causing abdominal aorta narrowing.
It often presents with severe hypertension and involves renal and visceral artery stenosis.
Current treatments aim to relieve stenosis while preserving organ function.

Observation:

Three adolescents with middle aortic syndrome underwent staged surgical repair.
The procedures involved angioplasty, renal autotransplantation, and aortic bypass grafting.
Stenoses of the aorta, renal arteries, and visceral arteries were addressed sequentially.

Findings:

All patients experienced successful recovery and returned to full activity.
Postoperative renal function remained stable, with no significant rise in BUN or creatinine.
Long-term follow-up (2-10 years) demonstrated well-functioning reconstructions.

Implications:

Staged vascular repair is a viable and effective strategy for middle aortic syndrome in children.
This approach minimizes the risk of renal ischemia and preserves native arterial tissue.
Successful outcomes suggest this method can lead to durable reconstructions and good long-term renal perfusion.

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