Annals of Pediatric Cardiology
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CASE REPORT
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Umbilical artery catheter, aortic dissection, carotid cannulation, and pseudoaneurysm in a neonate: A tale of propagating pathology


1 Department of Pediatric Intensive Care, Royal Brompton Hospital, London, United Kingdom
2 Department of Radiology, Royal Brompton Hospital, London, United Kingdom
3 Department of Pediatric Interventional Cardiology, Royal Brompton Hospital, London, United Kingdom
4 Department of Congenital Heart Disease Surgery, Royal Brompton Hospital, London, United Kingdom
5 Department of Aortic and Vascular Surgery, Royal Brompton Hospital, London, United Kingdom
6 Department of Pediatric Intensive Care; Department of Anesthesia and Critical Care, Royal Brompton Hospital, London, United Kingdom

Correspondence Address:
Justin Wang,
Paediatric Intensive Care Unit, Royal Brompton Hospital, London
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/apc.APC_67_19

Arterial dissections are uncommon in neonates. Complications include thrombosis, bleeding, dissection, aneurysm and pseudoaneurysm. We report an unusual case of multisite pathology (dissection and pseudoaneurysm) following common vascular interventions. A term neonate with antenatal diagnosis of congenital heart block secondary to maternal lupus deteriorated clinically at 5 days of life. He was found to have an abdominal aortic thrombus secondary to abdominal aortic dissection, following umbilical arterial catheter placement. Attempted percutaneous treatment was complicated by dissection of the left common carotid artery and formation of a large pseudoaneurysm. Neonatal lupus is associated with weakened vessel wall which may be vulnerable to injury from line placement and endovascular interventions. Various options are available to manage arterial dissection, thrombus, and pseudoaneurysm, but consequences of these options need to be carefully weighed to minimize further complications.


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    -  Wang J
    -  Semple T
    -  Bautista-Rodriguez C
    -  Hoschtitzky A
    -  Cheshire N
    -  Chan-Dominy A
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