Aortopexy Complicated by ST Segment Elevations in a Four-Month-Old Infant

Area of Science:

• Pediatric Cardiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Severe tracheomalacia necessitates surgical intervention, such as thoracoscopic aortopexy, in infants.
• Intraoperative complications, though rare, require vigilant monitoring and rapid response.
• Electrocardiogram (ECG) abnormalities in pediatric patients warrant thorough investigation.

Observation:

• A four-month-old infant undergoing thoracoscopic aortopexy developed significant ST segment elevations on ECG.
• Intraoperative echocardiography did not reveal structural cardiac abnormalities to explain the ECG changes.
• Persistent ST segment elevations were noted for 48 hours post-procedure without hemodynamic compromise.

Findings:

• The infant's ST segment elevations resolved spontaneously with normal troponin levels.
• The patient was discharged without any cardiac sequelae.
• This case highlights a rare occurrence of ST segment elevations in a pediatric patient without congenital heart disease.

Implications:

• Emphasizes the importance of recognizing and managing ST segment elevations in pediatric surgical patients.
• Suggests the need for a systematic workup to determine the etiology of intraoperative ECG changes.
• Underscores potential morbidity and mortality associated with unrecognized ST segment elevations in children.