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Aortic Dissection in a Neonate Receiving Extracorporeal Life Support Therapy: A Case Report.

Shivanand S Medar1, Arun Chopra1, T K Susheel Kumar2

  • 1From the Department of Paediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, New York.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 10, 2024
PubMed
Summary

Extracorporeal life support (ECLS) can cause rare aortic dissection in neonates. Conservative management of this complication, even with organ injury, led to a good outcome in a reported case.

Keywords:
ECMOECMO cannula complicationarterial dissectionneonatal aortic dissection

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Area of Science:

  • Pediatric Cardiology
  • Neonatal Intensive Care
  • Cardiovascular Surgery

Background:

  • Extracorporeal life support (ECLS) is vital for neonates with cardiorespiratory failure.
  • Complications, including aortic dissection, can arise during ECLS therapy.
  • Neonatal aortic dissection is rare, and its outcomes are not well-documented.

Purpose of the Study:

  • To report a case of extensive type B aortic dissection in a neonate on ECLS.
  • To discuss the conservative management of neonatal aortic dissection associated with ECLS.
  • To review the literature on this rare complication.

Main Methods:

  • Case report of a neonate with tachycardia-induced cardiomyopathy and Wolf Parkinson White (WPW) syndrome on ECLS.
  • Diagnosis of aortic dissection and abdominal organ ischemia after ECLS arterial cannula adjustment.
  • Management involved rapid decannulation and conservative treatment of the aortic dissection.

Main Results:

  • The neonate developed extensive type B aortic dissection and ischemic injury to abdominal organs.
  • Conservative management of the aortic dissection resulted in a favorable outcome.
  • The patient was successfully decannulated from ECLS.

Conclusions:

  • Neonatal aortic dissection is a rare but serious complication of ECLS.
  • Conservative management can be successful even in cases with associated organ injury.
  • This case highlights the importance of vigilant monitoring and tailored management strategies for ECLS-related complications.