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Ann Thorac Surg 2005;80:726-729
© 2005 The Society of Thoracic Surgeons

Case report

Mycotic Aneurysm of the Descending Thoracic Aorta in a 2-kg Neonate

Nathalie Roy, MD a , Anthony Azakiea, MD a , Anita J. Moon-Grady, MD b , Dominic J. Blurton, MD b , Tom R. Karl, MD a , *

a Division of Pediatric Cardiothoracic Surgery, Children’s Hospital, University of California, San Francisco, California
b Division of Pediatric Cardiology, Children’s Hospital, University of California, San Francisco, California

Accepted for publication January 28, 2004.

* Address reprint requests to Dr Karl, Division of Pediatric Cardiothoracic Surgery, University of California, San Francisco, 505 Parnassus Ave, Room S-549, San Francisco, CA94143-0118 (Email: karlt{at}surgery.ucsf.edu).

Umbilical artery catheterization is often performed in critically ill neonates. Infection and thromboembolic events are relatively frequent complications, but aneurysm formation is rare. We describe the case of a premature baby who developed a rapidly expanding aneurysm of the descending thoracic aorta, secondary to a highly placed infected umbilical catheter. The rapid progression under medical therapy prompted us to replace the thoracic aorta with an 8-mm polytetrafluoroethylene graft, using extracorporeal circulation and core cooling. The baby had an excellent recovery and was discharged home after a prolonged antibiotic course. He is being followed with repeated imaging studies for a small abdominal aneurysm. We describe a novel approach to this rare and complicated problem and provide a review of the literature on the subject.






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