RESUMEN
Atrial septal hematoma (ASH) has been reported mostly in adult patients to occur after spontaneous ascending aortic dissection (Circulation 46(3):537-545, 1972) and after surgery for coronary artery (Anesthesiology 83(3):620-621, 1995), mitral valve, and aortic valve (Rev Esp Cardiol 55(8):867-871, 2002). ASH in the pediatric age group is rare, and to our knowledge only two cases have been published (Am J Perinatol 27(6):481-483, 2010; J Am Soc Echocardiogr 1087-1089, 1998). We report a case of ASH diagnosed by intraoperative transesophageal echocardiography in a 28-month-old child who underwent mitral valvuloplasty and left main coronary arterioplasty for anomalous origin of the left coronary artery from pulmonary artery. ASH subsided on its own within 24 h.
Asunto(s)
Anomalías Múltiples , Angioplastia Coronaria con Balón/efectos adversos , Tabique Interatrial , Valvuloplastia con Balón/efectos adversos , Anomalías de los Vasos Coronarios/cirugía , Hematoma/etiología , Insuficiencia de la Válvula Mitral/cirugía , Preescolar , Anomalías de los Vasos Coronarios/diagnóstico , Diagnóstico Diferencial , Ecocardiografía Transesofágica , Femenino , Hematoma/diagnóstico por imagen , Humanos , Complicaciones Intraoperatorias , Periodo Intraoperatorio , Insuficiencia de la Válvula Mitral/congénito , Insuficiencia de la Válvula Mitral/diagnóstico por imagenRESUMEN
Mycotic aneurysm after bacteremia is a rare diagnosis in children and adolescents. We report the case of a previously healthy adolescent who presented with chest pain and fever and who developed a mycotic aneurysm of the aorta after contracting community-acquired, methicillin-resistant Staphylococcus aureus. Early recognition of widening of the patient's superior mediastinum, noted during a comparison of the patient's initial and follow-up chest radiographs, prompted computed tomographic angiography of the chest and led to a timely diagnosis, rapid surgical intervention, and a good clinical outcome. To our knowledge, this is the first reported case of mycotic aortic aneurysm from community-acquired methicillin-resistant S. aureus in a healthy adolescent who had no predisposing cardiac or aortic anomalies.