Aortopulmonary collateral artery in prenatal exposure to carbamazepine – endovascular therapy and technical considerations: a case report

Journal of Medical Case Reports

Pietro Quaretti³  Giovanni Leati³  Lorenzo Paolo Moramarco³  Savina Mannarino¹  Valeria Calcaterra⁴  Gloria Pelizzo² 

[1] Department of the Mother and Child Health, Pediatric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy;Department of the Mother and Child Health, Pediatric Surgery Unit, IRCCS Policlinico San Matteo Foundation and University of Pavia, P.le Golgi n.2, Pavia, 27100, Italy;Unit of Interventional Radiology, IRCCS Policlinico San Matteo Foundation Pavia, Pavia, Italy;Department of Internal Medicine, University of Pavia, Pavia, Italy

关键词: Multidisciplinary;    Children;    Carbamazepine;    Plug occlusion;    Aortopulmonary collateral;   

Others  :  1231360
DOI  :  10.1186/s13256-015-0645-1

 received in 2015-01-24, accepted in 2015-06-30,  发布年份 2015

【 摘 要 】

Introduction

Aortopulmonary collateral arteries are an uncommon variant of alternative blood supply in cases of complex congenital heart disease. Although surgery may still be the classic approach for this condition, mini-invasive endovascular occlusion has been recently attempted as an alternative less traumatic procedure. Children born to women with epilepsy are at increased risk of congenital malformations.

Case presentation

A cardiovascular malformation in a 6-year-old white boy with prenatal exposure to carbamazepine is described. At birth, he underwent atrial-ventricular septal defects repair. At 6 years of age, he was diagnosed to have an aberrant aortopulmonary artery from the descending aorta. He presented with recurrent respiratory infections and no cardiovascular signs, but there was associated right upper lobe hyperperfusion. Collateral percutaneous plug embolization was performed because of risk for cardiorespiratory infections, pulmonary hypertension and atrioventricular dilatation. The post-releasing control showed a complete occlusion of the aberrant artery. A chest radiogram and computed tomography showed normalization of vascular pattern of his right lung at 9-months follow-up. No complications and no respiratory infections in the first follow-up year were observed. A good growth gain was obtained.

Conclusions

Plug embolization in an aortopulmonary collateral artery is an interesting alternative to surgery and is suitable for children with minor congenital heart disease and without severe respiratory and/or cardiovascular symptoms. Management and long-term pediatric multidisciplinary follow-up is recommended. Prenatal exposure to carbamazepine could be considered in the pathogenesis and diagnosis of the malformation.

【 授权许可】

   
2015 Pelizzo et al.

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