Patent ductus arteriosus clipping and coarctation of the aorta

Discussion:

This infant presented with a continuous, loud murmur at a routine pediatric check-up.

On the cardiac echogram and CT angiogram, an infantile, pre ductal coarctation of the aorta and patent ductus arteriosus were confirmed.No other congenital cardiac anomalies were found, specifically, no tetralogy of Fallot, no Eisenmenger syndrome, no hypoplastic left heart and no pulmonary atresia. In addition, no aortic or mitral valve abnormalities were present.

The infant underwent open surgical management, specifically a left posterolateral thoracotomy and open dilatation of the coarctation and surgical clipping of the patent ductus arteriosus. 

Postoperatively, the infant presented with new onset of seizures and a request was made for an MRI brain examination. Although surgical hemostatic ligation clips are usually made of titanium and one can perform an MRI study immediately, a decision was made to rather perform a CT brain and wait a short period for healing and granulation tissue to form before performing an MRI study.

 

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