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Mycotic aneurysm of the descending aorta diagnosed by echocardiography
S Ozkutlu1, N Ozbarlas, A Bilgiç
1Department of Pediatric Cardiology, Hacettepe University, Ankara, Turkey.
Abstract:
We present a 3-yr-old girl with coarctation of aorta and patent ductus arteriosus in whom mycotic aneurysm and bacterial endarteritis developed postoperatively and was diagnosed by two-dimensional and Doppler echocardiography. Five weeks after the operation of ligation of ductus and resection of coarctated segment, the patient was readmitted with complaints of vomiting, fever and coughing. Bacterial endarteritis, empyema and septic arthritis were diagnosed. Suprasternal echocardiographic examination demonstrated an aneurysmatic appearance 60 x 65 mm in size at the location of coarctation. The patient died, most probably due to aortic rupture, before surgical treatment could be undertaken. Autopsy study confirmed our diagnosis.
Insights
A pediatric patient with coarctation of aorta and patent ductus arteriosus developed a mycotic aneurysm and bacterial endarteritis post-surgery. Despite diagnosis via echocardiography, the patient succumbed to probable aortic rupture before further intervention.
Area of Science:
- Cardiology
- Pediatric Surgery
- Infectious Diseases
Background:
- Coarctation of the aorta and patent ductus arteriosus are congenital heart defects requiring surgical intervention.
- Postoperative complications can include infections and vascular abnormalities.
- Early diagnosis and management are crucial for favorable outcomes.
Observation:
- A 3-year-old girl underwent surgery for coarctation of the aorta and patent ductus arteriosus.
- She was readmitted with symptoms of vomiting, fever, and coughing.
- Echocardiography revealed a large mycotic aneurysm at the coarctation site and signs of bacterial endarteritis.
Findings:
- The patient presented with bacterial endarteritis, empyema, and septic arthritis.
- A 60x65 mm mycotic aneurysm was identified at the coarctation site via suprasternal echocardiography.
- Autopsy confirmed the diagnoses, indicating probable aortic rupture as the cause of death.
Implications:
- This case highlights the rare but severe risk of mycotic aneurysm and bacterial endarteritis following aortic and ductal surgery in children.
- Two-dimensional and Doppler echocardiography are vital diagnostic tools for identifying these postoperative complications.
- Prompt recognition and aggressive management are essential, though outcomes can be fatal despite timely diagnosis.