Surgical Repair of an Arch and Descending Aortic Aneurysm in a Child

Pediatric thoracic aortic aneurysms are very rare, and almost all patients with such aneurysms have inflammatory or connective tissue diseases. This report describes a case involving 10-year-old girl who had an aortic arch and descending thoracic aortic aneurysm. Preoperative fluorine-18-fluorodeoxyglucose positron emission tomography combined with computed tomography showed an inflammatory lesion corresponding to the aneurysm's location. The ascending aorta, aortic arch, and descending thoracic aorta were replaced through median sternotomy and left thoracotomy with safe systemic and brain perfusion to avoid placing the anastomoses within the inflammatory lesion. The patient was discharged without complications, and an SMAD3 mutation was detected by postoperative mutational screening. (C) 2019 by The Society of Thoracic Surgeons