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Abstract:

The report is about giant false aneurysm of an extracranial part of the left internal carotid artery (ICA) in a patient aged one year and nine months. The reason of the complexity of diagnostics in this case was that the dissection of the ICA with formation of false aneurysm imitated the peritonsillar abscess' clinic. We have not found any descriptions of a similar cases of patients at such an early age in modern literature.

 

References

1.      Nikitina T.G., Kochurkova E.G., Petrosyan K.V., Alekyan B.G. Application of a stent-graft to correct a false aneurysm of the internal carotid artery. Creative. cardiol. 2015; 1: 66 [In Russ].

2.      Kalashnikova L.A. Dissection of arteries, blood supplying the brain, and disorders of cerebral circulation. Ann. clin. and exper. neurology. 2007; 1 (1): 41-49 [In Russ].

3.      Schievink W.I. Spontaneous dissection of the carotid and vertebral arteries. N. Engl. J. Med. 2001; 344: 898— 906. doi.org/10.1056/NEJM200103223441206.

4.      Fullerton HJ, JohnstonSC, Smith WS. Arterial dissection and stroke in children. Neurology, 2001; 57: 1155-1160.

5.      Kalashnikova L.A., Dobrynina L.A., Chechetkin A.O., Dreval M.V., Krotenkova M.V., Zakharkina M.V. Disorders of cerebral circulation in the dissection of the internal carotid and vertebral arteries. Algorithm of diagnostics. Nerve. disease. 2016; 2: 10-15 [In Russ].

6.      Kieslich M., Fiedler A., Heller C. et al. Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases. J. Neurol. Neurosurg. Psychiatry 2002; 73: 13-6.

7.      Seerig M.M., Chueiri L., Jacques J. et alt. Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat. Case Rep Otolaryngol. 2017; 2017: 467015. doi.org/10.1155/2017/4670152.

8.      Mazur E, Czerwinska E, Korona-Gtowniak I, Grochowalska A, Koziot-Montewka M. Epidemiology, clinical history and microbiology of peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2015 Mar; 34(3):549-54. doi.org/10.1007/s10096-014-2260-2.  

 

Abstract:

Stenting of the patent ductus arteriosus (PDA) is a relatively new method of palliative treatment ir children with congenital heart disease (CHD) and is an alternative to systemic-pulmonary shunt.

Aim: was to evaluate the efficacy of stenting in the PDA as a palliative care in children with pulmonary ductus-dependent hemodynamic in «Children Repubfcan Clinical Hospital» (CRCH).

Materials and methods: we analyzed data of 11 patients, with CHD and pulmonary ductus-dependent hemodynamics, who underwent stenting of PDA in CRCH for the period of 2007-2015. To assess the effectiveness of the procedure we took into consideration following data: clinical diagnosis; patient's condition before and after stenting of PDA.

Results: primary stenting of PDA was success in 10 patients, there was no severe complication and death. In 1 patient, there was a stent migration to the pulmonary artery, and due to the closure of the PDA and thus increasing cardiovascular insufficiency, child was taken to the corrective surgery, during which the stent was removed. As a result, in 10 successfully stented patients, in nearest follow-up observation period (15 to 28 days, mean 22 days), 7(70%) patients had a positive effect; in 3 patients progressing hypotension appeared on the 2nd day after the treatment, that leaded to pefrorming of endovascular procedures with Rashkind's method. In the later follow-up observation period, 6 of 7 patients had remaining satisfactory parameters of pulmonary hemodynamics (saturation ranged from 78% to 92%), before using of radical correction of pathology (in terms of 3 to 6 months.).

Conclusion: the stenting procedure for closing of PDA as a palliative treatment for infants with CHD and pulmonary ductus-dependent hemodynamics is effective to stabilize the severe clinical condition of patients prior to radical correction of defects in 60% of cases.  

 

References 

1.    Denise van der Linde, Elisabeth E.M. Konings, Maarten A. Slager, at al. Prevalence of Congenital Heart Disease Worldwide : A Systematic Review and Meta-Analysis. Journal of the American College of Cardiology. 2011; 58(21): 2241-2247.

2.    Emelyanchik E.Y., Kirilova Y.P., Yakshanova S.V., et al. Rezultaty primeneniya preparata prostoglandina E1 Vazaprostana v lechenii detey s duktus-zavisimym krovoobrascheniem. [Results of drug prostaglandin E1 Vazaprostan in treatment of children with ductus-dependent hemodynamics]. Sibirskoe meditsinskoe obozrenie. 2013; 6: 68-72. [In Russ].

3.    Mirolubov L.M. Vrozhdyennye poroki serdtsa u novorojdennykh I detey pervogo goda zhizni. [Congenital heart defects in newborns and infants]. Kazan. 2008: 33-51. [In Russ]

4.    Vakhvalova I.V., Idov Е.М., Shirogorova A.V.,et al. Duktus- zavisimye vrozhdennye poroki razvitiya serdtsa u detey: osobennosti klinicheskogo techeniya na etapakh do- i posleoperatsionnogo vykhazhivaniya. [Ductus-dependent congenital heart disease in children: clinical features at stages of pre- and postoperative nursing.] Vestnik uralskoy meditsynskoy akademicheskoy nauki. 2008; 2: 47-52. [In Russ]

5.    Bokeriya L.A., Alekyan B.G. Rukovodstvo po rentgenendovaskulyarnoy hirurgii serdtsa I sosudov. [Guidelines for endovascular surgery of the heart and blood vessels. The 3 volumes.] Т 2. Moskow. 2013; 289-303. [In Russ].

6.    Berishvili I.I., Garibyan V.A., Aleksii-Meskhishvili V.V., et al. Priobretyennaya deformastiya legochnoy arterii posle nalozheniya mezharterialnogo anastomoza u detey rannego vozrasta. [Acquired deformity of the pulmonary artery anastomosis after the imposition between arterial in infants]. Grudnaya khirurgiya. 1978; 5: 51-56. [In Russ]

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